| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,801.89 | $7,762.47 | $16,595.87 | |
Aetna
| Professional | $3,801.89 | $3,801.89 | $9,120.11 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $380.19 | $1,230.27 | $3,548.13 |