| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $380.19 | $645.65 | $870.96 | |
Aetna
| Professional | $263.03 | $281.84 | $398.11 | |
Molina
| Professional | $39.81 | $39.81 | $39.81 | |
United
| Facility | $316.23 | $316.23 | $416.87 | |
United
| Professional | $147.91 | $208.93 | $776.25 |