| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $550.28 | $4,376.00 | $63,777.14 | |
Medcost
| Facility | $550.28 | $667.35 | $1,392.79 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $6,921.59 | $8,723.79 | $16,394.00 |