| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,089.30 | $4,786.30 | $11,481.54 | |
Medcost
| Facility | $3,019.95 | $3,981.07 | $6,309.57 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $40,738.03 | $40,738.03 |