| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.58 | $422.79 | $7,278.00 | |
Medcost
| Facility | $194.58 | $385.01 | $623.49 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $980.12 | $980.12 | $16,394.00 |