| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $308.79 | $2,145.78 | $7,838.38 | |
Aetna
| Professional | $308.79 | $319.29 | $319.29 | |
Molina
| Professional | $50.00 | $85.00 | $3,500.00 | |
United
| Facility | $200.00 | $1,084.00 | $1,401.00 | |
United
| Professional | $384.86 | $460.53 | $635.49 |