| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $268.25 | $2,730.70 | $10,087.00 | |
Medcost
| Facility | $268.25 | $399.11 | $678.61 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $1,005.64 | $9,496.40 | $26,542.00 |