| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,511.89 | $4,168.69 | $10,000.00 | |
Medcost
| Facility | $2,511.89 | $3,715.35 | $6,165.95 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $45,708.82 | $45,708.82 |