| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,511.89 | $2,511.89 | $2,511.89 | |
Aetna
| Professional | $95.50 | $2,398.83 | $2,511.89 | |
Molina
| Professional | $30.20 | $44.67 | $60.26 | |
Select Health
| Professional | $3,090.30 | $3,090.30 | $3,548.13 |