| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,329.83 | $7,439.00 | $12,084.77 | |
Medcost
| Facility | $1,329.83 | $1,831.13 | $3,311.86 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $8,736.14 | $10,558.66 |