| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,156.89 | $1,838.22 | $12,247.00 | |
Medcost
| Facility | $1,156.89 | $1,719.97 | $1,932.29 | |
United
| Facility | $5,293.00 | $12,216.00 | $19,066.00 | |
Wellcare
| Facility | $55.00 | $55.00 | $11,879.05 |