| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,136.38 | $7,439.00 | $10,150.48 | |
Medcost
| Facility | $2,136.38 | $2,739.03 | $5,621.84 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $24,022.92 | $29,581.32 |