| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.15 | $25.36 | $36.24 | |
Aetna
| Professional | $24.15 | $24.15 | $70.25 | |
Molina
| Professional | $38.25 | $50.00 | $80.00 | |
United
| Facility | $1,193.85 | $1,737.50 | $2,814.11 | |
United
| Professional | $29.24 | $36.34 | $85.64 |