| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,905.46 | $1,905.46 | $3,162.28 | |
Molina
| Professional | $7,585.78 | $7,585.78 | $7,585.78 | |
Providence
| Facility | $2,238.72 | $4,897.79 | $6,918.31 | |
Providence
| Professional | $2,630.27 | $5,495.41 | $7,079.46 | |
United
| Professional | $1,047.13 | $1,047.13 | $2,089.30 |