| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,318.26 | $3,311.31 | $10,471.29 | |
Medcost
| Facility | $1,318.26 | $1,659.59 | $2,511.89 | |
United
| Facility | $2,511.89 | $7,244.36 | $10,471.29 | |
Wellcare
| Facility | $56.23 | $16,218.10 | $16,218.10 |