| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $558.41 | $886.04 | $7,439.00 | |
Medcost
| Facility | $558.41 | $670.10 | $890.52 | |
United
| Facility | $1,064.00 | $3,906.00 | $6,388.00 | |
Wellcare
| Facility | $55.00 | $4,174.47 | $5,080.88 |