| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $954.99 | $2,630.27 | $10,471.29 | |
Medcost
| Facility | $676.08 | $831.76 | $1,380.38 | |
United
| Facility | $1,995.26 | $7,244.36 | $10,471.29 | |
Wellcare
| Facility | $5,754.40 | $5,754.40 | $33,884.42 |