| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $263.17 | $568.15 | $7,278.00 | |
Medcost
| Facility | $263.17 | $398.69 | $577.35 | |
United
| Facility | $361.00 | $896.00 | $2,229.00 | |
Wellcare
| Facility | $1,866.60 | $1,866.60 | $16,394.00 |