| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $160.22 | $7,838.38 | $7,838.38 | |
Aetna
| Professional | $84.00 | $160.22 | $166.67 | |
Molina
| Professional | $60.00 | $85.00 | $1,500.00 | |
Providence
| Facility | $84.00 | $84.00 | $84.00 | |
United
| Facility | $7,315.00 | $11,259.00 | $12,494.00 | |
United
| Professional | $187.30 | $239.62 | $348.31 |