| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,491.69 | $7,439.00 | |
Medcost
| Facility | $2,238.94 | $3,121.47 | $5,653.12 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $18,925.02 | $23,377.59 |