| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.90 | $2,145.78 | $7,838.38 | |
Aetna
| Professional | $213.90 | $221.15 | $503.00 | |
Molina
| Professional | $60.00 | $85.00 | $556.67 | |
Providence
| Facility | $121.69 | $292.45 | $503.00 | |
United
| Facility | $790.00 | $9,127.00 | $13,891.00 | |
United
| Professional | $269.77 | $342.16 | $519.82 |