| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.25 | $1,949.84 | $9,549.93 | |
Medcost
| Facility | $501.19 | $741.31 | $1,230.27 | |
United
| Facility | $11,220.18 | $26,302.68 | $46,773.51 | |
Wellcare
| Facility | $15,848.93 | $43,651.58 | $43,651.58 | |
Wellcare
| Facility | 53 | $8,709.64 | $8,709.64 | $8,709.64 |