| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.25 | $1,949.84 | $8,709.64 | |
Medcost
| Facility | $776.25 | $954.99 | $1,445.44 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $14,454.40 | $14,454.40 |