| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $17.02 | $17.02 | $17.02 | |
BCBS
| Facility | $15.88 | $15.88 | $15.88 | |
Medcost
| Facility | $17.02 | $17.02 | $25.58 | |
United
| Professional | $16.64 | $17.79 | $20.30 | |
Wellcare
| Facility | $75.00 | $97.23 | $97.23 |