| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.06 | $297.06 | $297.06 | |
Molina
| Professional | $100.00 | $100.00 | $100.00 | |
United
| Facility | $436.00 | $436.00 | $436.00 | |
United
| Professional | $363.16 | $414.08 | $896.04 |