| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,134.30 | $1,615.00 | $7,439.00 | |
Medcost
| Facility | $977.00 | $1,517.38 | $2,762.47 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $17,624.64 | $21,305.12 |