| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $940.09 | $1,483.08 | $6,953.60 | |
Medcost
| Facility | $940.09 | $1,296.15 | $2,378.41 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $6,207.60 | $7,660.94 |