| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,507.37 | $3,038.00 | $4,387.00 | |
Aetna
| Professional | $1,201.78 | $1,507.37 | $1,507.37 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 | |
United
| Facility | $658.00 | $4,445.00 | $4,912.00 |