| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
BCBS
| Professional | $49.76 | $1,518.43 | $1,518.43 | |
Medcost
| Facility | $30.00 | $31.80 | $51.00 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |