| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $456.13 | $950.26 | $1,824.51 | |
Aetna
| Professional | $456.13 | $760.21 | $760.21 | |
Molina
| Professional | $942.66 | $991.32 | $991.32 | |
Providence
| Facility | $766.29 | $766.29 | $766.29 | |
Providence
| Professional | $641.62 | $641.62 | $729.80 | |
United
| Facility | $547.35 | $547.35 | $547.35 | |
United
| Professional | $255.43 | $255.43 | $364.90 |