| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.35 | $380.72 | $5,449.00 | |
Cigna
| Facility | $201.46 | $201.46 | $201.46 | |
Medcost
| Facility | $117.35 | $288.10 | $459.38 | |
United
| Facility | $405.00 | $2,376.00 | $3,517.00 | |
Wellcare
| Facility | $55.00 | $577.84 | $577.84 |