| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,038.00 | $4,312.00 | $5,743.00 | |
Aetna
| Professional | $2,843.00 | $2,843.00 | $4,387.00 | |
Molina
| Professional | $45.00 | $45.00 | $60.00 | |
United
| Facility | $1,078.00 | $1,556.00 | $4,495.00 |