| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $267.74 | $418.80 | $7,439.00 | |
Medcost
| Facility | $267.74 | $329.99 | $475.32 | |
United
| Facility | $3,366.00 | $9,541.00 | $14,589.00 | |
Wellcare
| Facility | $55.00 | $600.72 | $1,275.80 |