| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medcost
| Professional | $1,778.28 | $1,778.28 | $1,778.28 | |
United
| Facility | $954.99 | $4,786.30 | $8,317.64 | |
Wellcare
| Facility | $56.23 | $7,413.10 | $7,413.10 | |
Wellcare
| Facility | AS | $741.31 | $741.31 | $741.31 |