| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,312.60 | $7,439.00 | |
Medcost
| Facility | $2,292.00 | $2,859.92 | $4,590.76 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $27,041.28 | $31,966.56 |