| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $57.54 | $57.54 | $57.54 | |
Medcost
| Professional | $25.12 | $25.12 | $25.12 | |
Medcost
| Facility | $18.20 | $41.69 | $70.79 | |
Wellcare
| Facility | $117.49 | $117.49 | $117.49 | |
Wellcare
| Professional | $199.53 | $199.53 | $218.78 |