| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,373.94 | $7,439.00 | |
Medcost
| Facility | $2,301.00 | $2,852.51 | $6,175.48 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $27,248.64 | $32,579.16 |