| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $947.23 | $1,572.02 | $7,807.05 | |
Medcost
| Facility | $947.23 | $1,314.89 | $2,317.60 | |
Medcost
| Facility | AS | $151.75 | $184.08 | $309.37 |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $55.00 | $6,178.13 | $13,856.55 | |
Wellcare
| Facility | AS | $212.07 | $230.98 | $1,314.53 |