| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,318.26 | $2,089.30 | $8,709.64 | |
Medcost
| Facility | $1,318.26 | $1,737.80 | $2,691.53 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $15,135.61 | $15,135.61 |