| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $246.72 | $7,838.38 | $7,838.38 | |
Aetna
| Professional | $242.12 | $246.72 | $256.66 | |
Molina
| Professional | $60.00 | $60.00 | $1,500.00 | |
Providence
| Facility | $321.52 | $321.52 | $321.52 | |
United
| Facility | $3,085.00 | $4,262.00 | $17,636.00 | |
United
| Professional | $349.15 | $417.45 | $599.60 |