| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,818.38 | $4,466.84 | $10,715.19 | |
Medcost
| Facility | $2,818.38 | $3,715.35 | $5,754.40 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $39,810.72 | $39,810.72 |