| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $433.77 | $433.77 | $433.77 | |
Aetna
| Professional | $917.98 | $1,060.57 | $1,060.57 | |
Moda Health
| Facility | $973.06 | $1,060.57 | $1,357.53 | |
Molina
| Professional | $30.00 | $55.00 | $3,500.00 |