| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,540.35 | $1,618.64 | $7,439.00 | |
Medcost
| Facility | $1,540.35 | $2,074.34 | $3,800.31 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $23,265.28 | $28,089.60 |