| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,479.11 | $3,715.35 | $8,709.64 | |
Medcost
| Facility | $1,479.11 | $1,778.28 | $2,754.23 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $26,915.35 | $26,915.35 |