| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,628.00 | $4,500.00 | $7,205.00 | |
Aetna
| Professional | $4,500.00 | $4,500.00 | $7,205.00 | |
Molina
| Professional | $30.00 | $3,500.00 | $3,900.00 | |
United
| Facility | $11,800.00 | $26,422.00 | $29,092.00 |