| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,189.69 | $4,561.88 | $10,500.00 | |
Aetna
| Professional | $2,189.69 | $3,649.50 | $3,649.50 | |
Molina
| Professional | $5,425.00 | $5,705.00 | $5,705.00 | |
Providence
| Professional | $3,080.18 | $3,080.18 | $3,080.18 | |
United
| Professional | $1,226.23 | $1,226.23 | $1,751.76 |