| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.71 | $45.71 | $45.71 | |
Aetna
| Professional | $19.05 | $19.95 | $23.99 | |
Molina
| Professional | $2.75 | $2.75 | $2.75 | |
United
| Facility | $20.42 | $20.42 | $20.42 | |
United
| Professional | $19.50 | $19.50 | $19.50 |