| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $4,021.92 | $7,439.00 | |
Medcost
| Facility | $4,021.92 | $5,085.43 | $10,797.37 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $62,700.96 | $73,900.48 |