| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $537.03 | $912.01 | |
Medcost
| Facility | $181.97 | $323.59 | $549.54 | |
United
| Facility | $363.08 | $812.83 | $1,949.84 | |
Wellcare
| Facility | $1,122.02 | $1,548.82 | $1,548.82 |