| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.17 | $7,838.38 | $7,838.38 | |
Aetna
| Professional | $185.01 | $214.17 | $225.89 | |
Molina
| Professional | $60.00 | $85.00 | $292.10 | |
United
| Professional | $243.00 | $280.79 | $388.80 |