| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $654.62 | $1,985.43 | $1,985.43 | |
Molina
| Professional | $32.34 | $32.34 | $620.36 | |
Providence
| Facility | $507.27 | $624.23 | $637.21 | |
United
| Professional | $482.81 | $655.71 | $931.50 |