| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $810.64 | $1,278.11 | $7,439.00 | |
Medcost
| Facility | $766.91 | $1,169.52 | $1,694.24 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $12,126.88 | $14,592.00 |