| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $397.22 | $808.55 | $7,278.00 | |
Medcost
| Facility | $397.22 | $580.71 | $850.99 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $2,802.48 | $2,802.48 | $16,394.00 |