| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $35.00 | $50.00 | $529.27 | |
Molina
| Professional | $110.58 | $420.00 | $1,500.00 | |
Providence
| Professional | $490.00 | $543.90 | $586.25 | |
United
| Professional | $47.00 | $59.00 | $90.00 |