| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,796.41 | $4,123.79 | $16,059.00 | |
Medcost
| Facility | $1,664.13 | $2,508.17 | $3,754.50 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $11,575.83 | $13,858.88 |