| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,778.28 | $1,778.28 | $1,778.28 | |
Aetna
| Professional | $1,737.80 | $1,819.70 | $2,089.30 | |
BCBS
| Professional | $151.36 | $151.36 | $151.36 | |
Molina
| Professional | $39.81 | $39.81 | $1,819.70 | |
United
| Professional | $2,290.87 | $2,290.87 | $2,290.87 |