| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,245.00 | $1,615.00 | $10,924.00 | |
Aetna
| Professional | $1,245.00 | $1,245.00 | $1,615.00 | |
United
| Facility | $905.00 | $2,417.00 | $4,102.00 | |
Wellcare
| Facility | $55.00 | $55.00 | $55.00 |