| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,174.90 | $3,890.45 | $4,168.69 | |
United
| Professional | $6.76 | $8.51 | $16.98 | |
Wellcare
| Facility | $134.90 | $134.90 | $134.90 | |
Wellcare
| Professional | $204.17 | $204.17 | $204.17 |