| 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 | $378.05 | |
Molina
| Professional | $73.72 | $280.00 | $1,500.00 | |
Providence
| Professional | $350.00 | $388.50 | $418.75 | |
United
| Professional | $47.00 | $60.00 | $90.00 |