| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $549.54 | $1,380.38 | $8,709.64 | |
Medcost
| Facility | $288.40 | $398.11 | $707.95 | |
United
| Facility | $2,754.23 | $10,232.93 | $23,988.33 | |
Wellcare
| Facility | $56.23 | $10,232.93 | $10,232.93 |