| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $368.61 | $6,050.74 | $17,026.71 | |
Medcost
| Facility | $368.61 | $459.74 | $912.53 | |
United
| Facility | $2,353.00 | $6,885.00 | $9,872.90 | |
Wellcare
| Facility | $1,389.64 | $12,623.50 | $26,542.00 |