| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $569.29 | $1,186.01 | $2,277.15 | |
Aetna
| Professional | $569.29 | $948.81 | $948.81 | |
Molina
| Professional | $1,176.53 | $1,237.25 | $1,237.25 | |
Providence
| Facility | $956.40 | $956.40 | $956.40 | |
Providence
| Professional | $800.80 | $800.80 | $910.86 | |
United
| Professional | $318.80 | $318.80 | $455.43 |