| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.80 | $588.84 | $5,495.41 | |
Medcost
| Facility | $138.04 | $208.93 | $346.74 | |
United
| Facility | $1,995.26 | $7,244.36 | $10,471.29 | |
Wellcare
| Facility | $5,495.41 | $5,495.41 | $19,498.45 |