| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $7,762.47 | $7,762.47 | |
Aetna
| Professional | $60.26 | $77.62 | $1,995.26 | |
Molina
| Professional | $60.26 | $60.26 | $85.11 | |
Providence
| Facility | $75.86 | $75.86 | $173.78 | |
United
| Facility | $3,090.30 | $5,128.61 | $19,498.45 | |
United
| Professional | $93.33 | $125.89 | $169.82 |