| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,414.07 | $2,263.44 | $13,697.60 | |
Medcost
| Facility | $1,414.07 | $2,050.40 | $2,913.51 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $15,354.02 | $18,381.55 |