| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.28 | $575.28 | $575.28 | |
Aetna
| Professional | $575.28 | $575.28 | $575.28 | |
BCBS
| Professional | $45.60 | $49.76 | $60.00 | |
Medcost
| Facility | $575.28 | $575.28 | $690.34 | |
Wellcare
| Facility | $100.00 | $759.90 | $759.90 |