| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $2,491.60 | $7,439.00 | |
Medcost
| Facility | $2,491.60 | $3,204.92 | $6,592.03 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $39,633.28 | $46,808.48 |