| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $992.39 | $1,561.67 | $6,953.60 | |
Medcost
| Facility | $992.39 | $1,292.88 | $2,617.55 | |
United
| Facility | $1,172.00 | $4,086.00 | $7,778.00 | |
Wellcare
| Facility | $55.00 | $9,703.90 | $11,616.00 |