| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $8,128.31 | $17,782.79 | $17,782.79 | |
Aetna
| Professional | $3,467.37 | $4,265.80 | $6,456.54 | |
Molina
| Professional | $8,128.31 | $8,128.31 | $11,220.18 | |
Providence
| Facility | $3,467.37 | $6,309.57 | $10,000.00 | |
Providence
| Professional | $5,495.41 | $5,754.40 | $5,754.40 | |
United
| Professional | $2,187.76 | $2,187.76 | $3,162.28 |