| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.64 | $2,145.78 | $7,838.38 | |
Aetna
| Professional | $61.26 | $79.64 | $124.33 | |
Molina
| Professional | $50.00 | $70.00 | $121.63 | |
Providence
| Facility | $61.26 | $73.13 | $99.92 | |
United
| Facility | $177.55 | $177.55 | $177.55 | |
United
| Professional | $82.03 | $86.98 | $169.61 |