| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $930.68 | $1,315.22 | $10,561.00 | |
Medcost
| Facility | $910.29 | $1,005.31 | $1,369.24 | |
United
| Facility | $3,366.00 | $9,541.00 | $14,589.00 | |
Wellcare
| Facility | $5,162.64 | $9,001.70 | $26,542.00 |