| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $542.00 | $1,042.64 | $12,247.00 | |
Medcost
| Facility | $542.00 | $722.00 | $1,124.00 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $3,840.12 | $3,840.12 | $26,542.00 |