| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $407.62 | $3,152.78 | $7,278.00 | |
Medcost
| Facility | $384.31 | $579.29 | $851.93 | |
Medcost
| Facility | AS | $65.33 | $81.09 | $134.26 |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $3,442.14 | $4,153.59 | |
Wellcare
| Facility | AS | $91.53 | $100.67 | $195.45 |