| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $257.70 | $1,606.42 | $7,968.00 | |
Medcost
| Facility | $257.70 | $1,116.11 | $1,953.53 | |
United
| Facility | $3,366.00 | $9,541.00 | $14,589.00 | |
Wellcare
| Facility | $55.00 | $2,081.44 | $2,081.44 |