| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.30 | $500.00 | $1,831.00 | |
Aetna
| Professional | $140.30 | $159.44 | $202.48 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $166.99 | $252.32 | $530.44 |