| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $445.15 | $2,536.00 | $15,291.00 | |
Medcost
| Facility | $445.15 | $621.66 | $1,177.49 | |
United
| Facility | $11,832.00 | $23,512.00 | $39,350.00 | |
Wellcare
| Facility | $2,076.80 | $16,026.00 | $42,018.80 |