| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $50.12 | |
Medcost
| Facility | $1.58 | $1.58 | $1.58 | |
United
| Facility | $0.04 | $1.66 | $4.17 | |
United
| Professional | $1.66 | $4.17 | $4.17 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |