| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.41 | $165.33 | $7,362.00 | |
Medcost
| Facility | $98.99 | $124.00 | $228.51 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $559.32 | $5,819.45 | $12,000.00 |