| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,368.10 | $1,888.74 | $6,953.60 | |
Medcost
| Facility | $1,368.10 | $1,740.96 | $3,608.46 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $16,139.88 | $19,117.56 |