| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $494.33 | $7,367.00 | $8,442.00 | |
Medcost
| Facility | $494.33 | $641.30 | $1,239.94 | |
United
| Facility | $905.00 | $2,417.00 | $4,102.00 | |
Wellcare
| Facility | $3,191.16 | $5,444.45 | $26,542.00 |