| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.26 | $41.26 | $41.26 | |
Aetna
| Professional | $35.10 | $40.59 | $41.26 | |
Molina
| Professional | $49.47 | $60.00 | $85.00 | |
Providence
| Facility | $24.74 | $35.10 | $42.87 | |
United
| Professional | $61.63 | $82.01 | $116.01 |