| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.06 | $297.06 | $297.06 | |
BCBS
| Facility | $634.97 | $634.97 | $634.97 | |
Medcost
| Facility | $297.06 | $297.06 | $386.18 | |
United
| Professional | $354.06 | $393.79 | $449.77 | |
Wellcare
| Facility | $769.68 | $2,686.60 | $2,686.60 |