| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $201.34 | $201.34 | $201.34 | |
Aetna
| Professional | $193.41 | $193.41 | $201.34 | |
Molina
| Professional | $60.00 | $85.00 | $297.46 | |
United
| Professional | $175.59 | $195.84 | $427.87 |