| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,375.04 | $1,375.04 | $1,375.04 | |
Aetna
| Professional | $1,371.43 | $1,415.58 | $1,665.34 | |
Molina
| Professional | $30.00 | $30.00 | $60.00 | |
United
| Professional | $1,342.67 | $1,807.43 | $1,807.43 |