| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.19 | $251.19 | $251.19 | |
Aetna
| Professional | $16.98 | $251.19 | $257.04 | |
BCBS
| Professional | $489.78 | $489.78 | $501.19 | |
Medcost
| Facility | $20.42 | $257.04 | $467.74 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 | |
Wellcare
| Professional | $12.30 | $12.30 | $15.49 |