| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $238.74 | $400.21 | $7,439.00 | |
Medcost
| Facility | $238.74 | $309.00 | $578.00 | |
United
| Facility | $905.00 | $2,417.00 | $4,102.00 | |
Wellcare
| Facility | $2,433.53 | $2,433.53 | $2,948.77 |