| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $289.08 | $797.79 | $7,278.00 | |
Medcost
| Facility | $289.08 | $488.20 | $773.06 | |
United
| Facility | $905.00 | $2,417.00 | $4,102.00 | |
Wellcare
| Facility | $2,024.64 | $2,024.64 | $16,394.00 |