| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.63 | $268.20 | $7,439.00 | |
Medcost
| Facility | $152.83 | $242.02 | $345.51 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $1,651.32 | $2,004.20 |