| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $18.62 | $23.99 | |
Aetna
| Professional | $15.85 | $16.98 | $19.95 | |
Medcost
| Facility | $17.78 | $18.62 | $20.89 | |
United
| Professional | $20.89 | $20.89 | $26.92 | |
Wellcare
| Facility | $151.36 | $151.36 | $151.36 |