| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,924.17 | $1,924.17 | $1,924.17 | |
Molina
| Professional | $32.34 | $32.34 | $582.79 | |
Providence
| Facility | $411.18 | $521.66 | $561.67 | |
United
| Professional | $464.35 | $623.14 | $885.33 |