| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $851.14 | $3,801.89 | $11,220.18 | |
Medcost
| Facility | $630.96 | $812.83 | $1,230.27 | |
United
| Facility | $2,398.83 | $7,244.36 | $10,471.29 | |
Wellcare
| Facility | $9,549.93 | $9,549.93 | $33,884.42 |