| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $297.14 | $579.01 | $5,449.00 | |
Medcost
| Facility | $297.14 | $500.00 | $814.21 | |
United
| Facility | $905.00 | $2,417.00 | $4,102.00 | |
Wellcare
| Facility | $2,417.38 | $2,417.38 | $12,000.00 |