| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $737.32 | $4,001.00 | $8,442.00 | |
Medcost
| Facility | $737.32 | $975.00 | $1,860.54 | |
United
| Facility | $3,500.00 | $8,736.00 | $13,997.00 | |
Wellcare
| Facility | $4,941.85 | $9,011.04 | $26,542.00 |