| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $784.00 | $936.00 | $2,010.00 | |
Aetna
| Professional | $805.20 | $805.20 | $805.20 | |
BCBS
| Professional | $139.00 | $139.00 | $139.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Facility | $624.00 | $1,236.00 | $5,253.00 |