| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $877.40 | $1,615.00 | $10,561.00 | |
Medcost
| Facility | $877.40 | $1,200.57 | $2,212.88 | |
United
| Facility | $3,366.00 | $9,541.00 | $14,589.00 | |
Wellcare
| Facility | $2,000.00 | $5,767.09 | $7,123.48 |