| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $660.99 | $3,000.30 | $10,453.00 | |
Medcost
| Facility | $660.99 | $743.00 | $1,054.82 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $3,732.24 | $5,819.45 | $26,542.00 |