| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $930.53 | $2,536.00 | $12,247.00 | |
Medcost
| Facility | $930.53 | $1,209.71 | $2,340.23 | |
United
| Facility | $2,526.00 | $7,659.00 | $10,502.00 | |
Wellcare
| Facility | $5,199.35 | $16,547.20 | $26,542.00 |