| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $331.13 | $831.76 | $8,709.64 | |
Medcost
| Facility | $331.13 | $512.86 | $891.25 | |
United
| Facility | $363.08 | $812.83 | $1,949.84 | |
Wellcare
| Facility | $56.23 | $2,089.30 | $2,089.30 |