| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,096.92 | $3,911.40 | $12,615.00 | |
Medcost
| Facility | $769.00 | $1,029.00 | $1,891.24 | |
United
| Facility | $3,366.00 | $9,541.00 | $14,589.00 | |
Wellcare
| Facility | $55.00 | $5,212.62 | $6,386.87 |