| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.23 | $1,698.24 | $2,238.72 | |
Aetna
| Professional | $190.55 | $316.23 | $436.52 | |
Molina
| Professional | $60.26 | $60.26 | $60.26 | |
United
| Professional | $147.91 | $147.91 | $208.93 |