| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,378.71 | $23,622.46 | $27,914.48 | |
Aetna
| Professional | $7,961.62 | $7,961.62 | $7,961.62 | |
Medcost
| Facility | $6,024.61 | $7,961.62 | $9,553.94 | |
Wellcare
| Facility | $100.00 | $100.00 | $5,913.52 |