| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,245.00 | $5,827.84 | $11,986.00 | |
Medcost
| Facility | $1,078.27 | $1,392.00 | $2,470.00 | |
Medcost
| Facility | 80 | $209.08 | $290.73 | $494.00 |
United
| Facility | $5,293.00 | $12,216.00 | $19,066.00 | |
Wellcare
| Facility | $7,096.81 | $11,879.05 | $26,542.00 |