| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $852.50 | $1,315.92 | $8,413.00 | |
Medcost
| Facility | $802.00 | $1,016.37 | $1,364.00 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $5,697.58 | $6,971.65 | $26,542.00 |