| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $888.97 | $3,875.00 | $10,087.00 | |
Medcost
| Facility | $868.75 | $1,203.00 | $2,132.87 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $55.00 | $5,880.14 | $7,198.87 |