| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,187.76 | $3,548.13 | $8,709.64 | |
Medcost
| Facility | $2,187.76 | $2,951.21 | $4,677.35 | |
United
| Facility | $1,174.90 | $3,890.45 | $6,918.31 | |
Wellcare
| Facility | $56.23 | $40,738.03 | $40,738.03 |