| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,845.32 | $7,439.00 | |
Medcost
| Facility | $2,845.32 | $3,635.57 | $7,538.31 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $33,564.60 | $39,638.28 |