| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,551.92 | $1,662.14 | $7,439.00 | |
Medcost
| Facility | $1,551.92 | $2,172.69 | $3,812.43 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $23,265.12 | $28,029.76 |