| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,062.00 | $12,075.00 | $21,886.00 | |
Aetna
| Professional | $9,062.00 | $9,062.00 | $17,247.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Facility | $659.00 | $6,107.00 | $8,818.00 |