| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $776.25 | $1,288.25 | $1,737.80 | |
Aetna
| Professional | $524.81 | $562.34 | $812.83 | |
Molina
| Professional | $16.98 | $21.38 | $50.12 | |
United
| Facility | $630.96 | $630.96 | $831.76 | |
United
| Professional | $295.12 | $416.87 | $1,548.82 |