| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.49 | $6.39 | $8.69 | |
Aetna
| Professional | $0.72 | $3.00 | $3.20 | |
Medcost
| Facility | $16.23 | $16.23 | $16.23 | |
Medcost
| Professional | $16.23 | $16.23 | $16.23 | |
Wellcare
| Facility | $100.00 | $100.00 | $162.46 |