| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $380.19 | $9,120.11 | $16,595.87 | |
Aetna
| Professional | $288.40 | $398.11 | $467.74 | |
Medcost
| Facility | $338.84 | $446.68 | $741.31 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $478.63 | $6,165.95 | $8,912.51 | |
United
| Professional | $354.81 | $478.63 | $870.96 |