| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.75 | $30.75 | $33.83 | |
Aetna
| Professional | $30.75 | $30.75 | $48.00 | |
Medcost
| Facility | $30.75 | $30.75 | $32.60 | |
Medcost
| Professional | $39.00 | $39.00 | $39.00 | |
United
| Professional | $24.28 | $24.28 | $28.65 | |
Wellcare
| Facility | $60.46 | $100.00 | $165.11 |