| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $180.72 | $180.72 | $243.53 | |
Aetna
| Professional | $176.47 | $180.72 | $211.76 | |
Medcost
| Facility | $180.72 | $191.56 | $233.87 | |
Medcost
| Professional | $201.98 | $201.98 | $201.98 | |
United
| Professional | $180.30 | $180.30 | $234.39 | |
Wellcare
| Facility | $212.61 | $212.61 | $212.61 |