| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,095.00 | $7,838.38 | $14,860.56 | |
Aetna
| Professional | $25,308.00 | $25,308.00 | $25,308.00 | |
Molina
| Professional | $60.00 | $60.00 | $85.00 | |
United
| Facility | $16,706.00 | $34,586.00 | $34,586.00 |