| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $225.97 | $360.39 | $7,439.00 | |
Medcost
| Facility | $214.35 | $331.14 | $472.28 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $524.45 | $1,090.17 |