| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $223.59 | $352.09 | $7,439.00 | |
Medcost
| Facility | $223.59 | $372.89 | $585.29 | |
Medcost
| Facility | AS | $36.00 | $52.50 | $82.60 |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $545.53 | $1,931.00 | |
Wellcare
| Facility | AS | $50.51 | $54.55 | $105.04 |