| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $977.24 | $2,398.83 | $7,762.47 | |
Medcost
| Facility | $616.60 | $851.14 | $1,318.26 | |
United
| Facility | $2,691.53 | $9,549.93 | $14,454.40 | |
Wellcare
| Facility | $9,332.54 | $9,332.54 | $28,840.32 |