| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $2,630.27 | $6,606.93 | $11,748.98 | |
United
| Professional | $114.82 | $169.82 | $281.84 | |
Wellcare
| Facility | $10,715.19 | $10,715.19 | $10,715.19 | |
Wellcare
| Professional | $1,318.26 | $1,380.38 | $1,380.38 |