| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $154.06 | $246.33 | $7,439.00 | |
Medcost
| Facility | $154.06 | $218.48 | $376.76 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $374.19 | $1,300.00 |