| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $745.14 | $1,168.51 | $7,439.00 | |
Medcost
| Facility | $745.14 | $1,043.20 | $1,960.84 | |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $55.00 | $4,824.47 | $13,856.55 |