| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,293.58 | $1,615.00 | $7,439.00 | |
Medcost
| Facility | $1,293.58 | $1,761.09 | $3,227.92 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $18,005.12 | $21,822.08 |