| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,174.90 | $3,890.45 | $4,168.69 | |
United
| Professional | $245.47 | $407.38 | $660.69 | |
Wellcare
| Facility | $794.33 | $794.33 | $794.33 | |
Wellcare
| Professional | $891.25 | $891.25 | $891.25 |