| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,884.03 | $3,715.35 | $4,897.79 | |
Aetna
| Professional | $1,548.82 | $2,818.38 | $2,818.38 | |
Molina
| Professional | $44.67 | $44.67 | $60.26 | |
United
| Facility | $3,019.95 | $5,128.61 | $15,848.93 |