| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,162.28 | $4,168.69 | $6,025.60 | |
Aetna
| Professional | $1,412.54 | $2,818.38 | $2,818.38 | |
Molina
| Professional | $30.20 | $44.67 | $44.67 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |