| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $4,897.79 | $10,964.78 | |
Aetna
| Professional | $1.00 | $2.00 | $7.94 | |
Molina
| Professional | $39.81 | $39.81 | $60.26 | |
United
| Facility | $43.65 | $44.67 | $44.67 | |
United
| Professional | $34.67 | $39.81 | $60.26 |