| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $46.68 | $51.75 | $62.98 | |
Molina
| Professional | $60.00 | $60.00 | $85.00 | |
Providence
| Facility | $49.68 | $69.36 | $87.08 | |
Providence
| Professional | $1,800,000.00 | $2,250,000.00 | $2,400,000.00 |