| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $148.03 | $148.03 | $148.03 | |
Aetna
| Professional | $145.47 | $148.03 | $156.10 | |
Molina
| Professional | $60.00 | $85.00 | $1,500.00 | |
United
| Professional | $197.12 | $246.39 | $353.91 |