| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.27 | $226.33 | $10,561.00 | |
Medcost
| Facility | $175.62 | $185.15 | $480.00 | |
Medcost
| Facility | 50 | $263.43 | $277.73 | $772.50 |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $428.23 | $2,538.00 | $26,542.00 |