| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.41 | $340.44 | $7,278.00 | |
Medcost
| Facility | $120.41 | $281.91 | $364.11 | |
United
| Facility | $1,728.00 | $3,733.00 | $6,543.00 | |
Wellcare
| Facility | $620.97 | $620.97 | $16,394.00 |