| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $346.74 | $6,309.57 | $13,803.84 | |
Medcost
| Facility | $186.21 | $239.88 | $407.38 | |
United
| Facility | $363.08 | $812.83 | $1,949.84 | |
Wellcare
| Facility | $15,848.93 | $15,848.93 | $15,848.93 |