| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,928.52 | $5,993.00 | $12,693.67 | |
Aetna
| Professional | $1,125.00 | $1,641.00 | $2,581.07 | |
United
| Facility | $5,293.00 | $12,216.00 | $19,066.00 | |
Wellcare
| Facility | $10,160.00 | $10,160.00 | $10,160.00 |