| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,943.28 | $9,120.11 | $21,877.62 | |
Aetna
| Professional | $9,120.11 | $9,120.11 | $9,120.11 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Facility | $2,454.71 | $6,760.83 | $9,120.11 |