| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $142.49 | $227.94 | $7,439.00 | |
Medcost
| Facility | $142.49 | $241.74 | $308.27 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $323.57 | $732.00 |