| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
BCBS
| Professional | $562.46 | $583.29 | $751.48 | |
Medcost
| Facility | $450.00 | $450.00 | $509.80 | |
Medcost
| Professional | $450.00 | $450.00 | $450.00 | |
United
| Professional | $432.81 | $633.70 | $1,167.30 | |
Wellcare
| Facility | $793.40 | $870.57 | $2,384.42 |