| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,584.89 | $3,890.45 | $13,803.84 | |
Medcost
| Facility | $1,023.29 | $1,412.54 | $2,344.23 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $9,549.93 | $9,549.93 |