| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $28.26 | $28.26 | $28.26 | |
BCBS
| Facility | $26.36 | $26.36 | $26.36 | |
Medcost
| Facility | $28.26 | $28.26 | $42.49 | |
United
| Professional | $27.64 | $29.54 | $33.59 | |
Wellcare
| Facility | $75.00 | $161.44 | $161.44 |