| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $820.26 | $5,807.03 | $11,270.00 | |
Medcost
| Facility | $820.26 | $1,105.40 | $2,066.53 | |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $5,398.05 | $22,231.55 | $26,542.00 |