| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,496.44 | $10,924.00 | |
Medcost
| Facility | $1,813.57 | $2,308.46 | $4,568.41 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $21,363.60 | $25,302.48 |