| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
United
| Facility | $1,174.90 | $3,890.45 | $4,168.69 | |
United
| Professional | $32.36 | $45.71 | $79.43 | |
Wellcare
| Facility | $457.09 | $457.09 | $457.09 | |
Wellcare
| Professional | $812.83 | $812.83 | $812.83 |