| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $3,253.56 | $7,439.00 | |
Medcost
| Facility | $3,253.56 | $4,711.62 | $8,582.24 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $37,440.72 | $44,703.60 | |
Wellcare
| Facility | 62 | $4,453.92 | $10,038.95 | $10,038.95 |