| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,493.52 | $7,439.00 | |
Medcost
| Facility | $2,267.00 | $3,182.12 | $6,258.89 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $25,665.20 | $31,724.88 |