| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $152.16 | $238.79 | $7,439.00 | |
Medcost
| Facility | $152.16 | $211.09 | $354.84 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $370.15 | $713.36 |