| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.07 | $313.02 | $7,278.00 | |
Medcost
| Facility | $127.07 | $257.73 | $408.49 | |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $855.00 | $855.00 | $16,394.00 |