| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,500.00 | $4,500.00 | $5,519.00 | |
Aetna
| Professional | $805.20 | $805.20 | $805.20 | |
Moda Health
| Facility | $805.20 | $805.20 | $1,030.66 | |
Molina
| Professional | $30.00 | $55.00 | $3,900.00 | |
United
| Facility | $675.00 | $3,700.00 | $26,104.00 |