| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,167.67 | $1,926.30 | $10,561.00 | |
Medcost
| Facility | $1,167.67 | $1,838.66 | $2,464.32 | |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $55.00 | $9,767.70 | $13,856.55 |