| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.08 | $1,288.25 | $6,760.83 | |
Medcost
| Facility | $363.08 | $501.19 | $776.25 | |
United
| Facility | $2,511.89 | $7,244.36 | $10,471.29 | |
Wellcare
| Facility | $9,332.54 | $9,332.54 | $45,708.82 |