| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.20 | $1,245.00 | $7,439.00 | |
Medcost
| Facility | $79.33 | $83.20 | $145.71 | |
Medcost
| Facility | AS | $11.17 | $11.62 | $17.92 |
United
| Facility | $117.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $147.13 | $151.86 | $3,779.00 | |
Wellcare
| Facility | AS | $11.76 | $15.19 | $40.89 |