| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $839.70 | $1,615.00 | $13,764.00 | |
Medcost
| Facility | $839.70 | $1,162.76 | $2,086.23 | |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $55.00 | $5,535.11 | $13,856.55 |