| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,799.00 | $9,062.00 | $20,498.00 | |
Aetna
| Professional | $9,062.00 | $9,062.00 | $9,062.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Facility | $4,252.00 | $26,459.00 | $63,302.00 |