| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,090.30 | $5,011.87 | $11,748.98 | |
Medcost
| Facility | $3,090.30 | $4,265.80 | $6,606.93 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $42,657.95 | $42,657.95 |