| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $721.17 | $10,087.00 | $12,615.00 | |
Medcost
| Facility | $721.17 | $1,201.78 | $1,689.37 | |
United
| Facility | $6,688.00 | $15,545.00 | $22,780.00 | |
Wellcare
| Facility | $4,736.47 | $12,650.00 | $27,770.10 |