| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,000.00 | $1,995.26 | $3,801.89 | |
Aetna
| Professional | $645.65 | $1,380.38 | $1,778.28 | |
Molina
| Professional | $21.38 | $25.12 | $50.12 | |
United
| Facility | $630.96 | $1,380.38 | $4,073.80 |