| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $155.79 | $155.79 | $155.79 | |
Aetna
| Professional | $117.37 | $155.79 | $155.79 | |
BCBS
| Facility | $163.76 | $163.76 | $163.76 | |
BCBS
| Professional | $158.75 | $214.68 | $231.39 | |
Medcost
| Facility | $155.79 | $155.79 | $210.89 | |
Medcost
| Professional | $138.75 | $138.75 | $138.75 | |
United
| Professional | $134.59 | $194.25 | $382.54 | |
Wellcare
| Facility | $340.58 | $340.58 | $972.33 |