| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,174.90 | $2,630.27 | $2,630.27 | |
Aetna
| Professional | $537.03 | $616.60 | $954.99 | |
Molina
| Professional | $1,174.90 | $1,174.90 | $1,621.81 | |
Providence
| Facility | $501.19 | $912.01 | $1,445.44 | |
Providence
| Professional | $794.33 | $831.76 | $831.76 | |
United
| Professional | $316.23 | $316.23 | $457.09 |