| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $760.00 | $1,390.80 | $1,542.80 | |
Aetna
| Professional | $600.40 | $1,390.80 | $1,542.80 | |
BCBS
| Facility | $760.00 | $760.00 | $760.00 | |
BCBS
| Professional | $760.00 | $760.00 | $760.00 | |
Molina
| Professional | $40.00 | $40.00 | $40.00 | |
United
| Professional | $319.20 | $456.00 | $1,140.00 |