| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $205.15 | $1,350.00 | $5,449.00 | |
Medcost
| Facility | $205.15 | $1,297.36 | $2,487.38 | |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $55.00 | $2,056.57 | $2,056.57 |