| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,862.09 | $6,456.54 | $8,128.31 | |
Medcost
| Facility | $2,089.30 | $2,754.23 | $4,265.80 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $28,840.32 | $28,840.32 |