| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $495.47 | $3,508.79 | $7,724.00 | |
Medcost
| Facility | $495.47 | $698.86 | $1,014.70 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $55.00 | $1,857.96 | $9,496.40 |