| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $275.64 | $663.40 | $5,449.00 | |
Medcost
| Facility | $275.64 | $482.13 | $797.00 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $1,950.36 | $1,950.36 | $12,000.00 |