| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $338.47 | $338.47 | $338.47 | |
Aetna
| Professional | $334.92 | $375.65 | $632.99 | |
Molina
| Professional | $85.00 | $260.89 | $1,500.00 | |
Providence
| Facility | $549.84 | $1,071.02 | $1,336.31 |