| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $448.23 | $6,953.60 | $7,993.00 | |
Medcost
| Facility | $448.23 | $646.00 | $1,126.08 | |
United
| Facility | $5,293.00 | $12,216.00 | $19,066.00 | |
Wellcare
| Facility | $55.00 | $5,079.47 | $13,486.75 |