| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,410.00 | $8,158.00 | $12,615.00 | |
Aetna
| Professional | $1,245.00 | $10,087.00 | $12,615.00 | |
United
| Facility | $10,829.00 | $22,655.00 | $29,047.00 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |