| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,912.95 | $3,194.10 | $3,510.00 | |
Aetna
| Professional | $1,386.45 | $3,194.10 | $3,510.00 | |
BCBS
| Facility | $782.27 | $782.27 | $782.27 | |
BCBS
| Professional | $782.27 | $782.27 | $782.27 | |
Molina
| Professional | $21.25 | $25.00 | $50.00 | |
United
| Professional | $737.10 | $1,053.00 | $2,995.73 |