| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,557.09 | $1,557.09 | $1,557.09 | |
Aetna
| Professional | $1,557.09 | $1,557.09 | $1,557.09 | |
BCBS
| Professional | $17,851.97 | $17,851.97 | $17,851.97 | |
Medcost
| Facility | $1,557.09 | $1,557.09 | $3,044.76 | |
Wellcare
| Facility | $80.00 | $100.00 | $100.00 |