| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.67 | $44.67 | $44.67 | |
Aetna
| Professional | $32.36 | $44.67 | $54.95 | |
Molina
| Professional | $50.12 | $60.26 | $85.11 | |
Providence
| Facility | $31.62 | $47.86 | $93.33 | |
United
| Facility | $263.03 | $575.44 | $575.44 | |
United
| Professional | $51.29 | $75.86 | $125.89 |