| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $608.75 | $979.22 | $10,561.00 | |
Medcost
| Facility | $608.75 | $674.00 | $951.18 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $3,440.16 | $6,887.55 | $26,542.00 |