| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,137.96 | $11,220.18 | $34,673.69 | |
Medcost
| Facility | $1,348.96 | $1,949.84 | $3,162.28 | |
United
| Facility | $6,760.83 | $15,135.61 | $22,908.68 | |
Wellcare
| Facility | $27,542.29 | $27,542.29 | $50,118.72 |