| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,537.23 | $1,615.00 | $7,439.00 | |
Medcost
| Facility | $1,592.82 | $2,025.90 | $4,209.47 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $18,741.96 | $22,202.52 |