| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,272.68 | $1,615.00 | $7,439.00 | |
Medcost
| Facility | $1,272.68 | $1,775.33 | $3,206.70 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $9,552.00 | $11,804.64 |