| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,615.00 | $8,442.00 | $10,561.00 | |
Aetna
| Professional | $50.90 | $8,442.00 | $10,561.00 | |
United
| Facility | $10,829.00 | $22,655.00 | $29,047.00 | |
Wellcare
| Facility | $100.00 | $100.00 | $100.00 |