| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $272.29 | $431.97 | $7,439.00 | |
Medcost
| Facility | $272.29 | $459.80 | $686.20 | |
Medcost
| Facility | AS | $36.40 | $75.23 | $101.16 |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $657.17 | $1,332.36 | |
Wellcare
| Facility | AS | $59.73 | $133.24 | $133.24 |