| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.63 | $183.55 | $1,482.15 | |
Medcost
| Facility | $0.90 | $123.63 | $138.93 | |
United
| Facility | $1,728.00 | $3,733.00 | $6,543.00 | |
Wellcare
| Facility | $55.00 | $291.89 | $4,989.20 |