| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,553.73 | $8,399.90 | $13,077.00 | |
Medcost
| Facility | $853.36 | $1,140.31 | $1,844.98 | |
United
| Facility | $5,293.00 | $12,216.00 | $19,066.00 | |
Wellcare
| Facility | $5,845.07 | $16,223.75 | $26,542.00 |