| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $4,998.68 | $4,998.68 | $4,998.68 | |
Health Alliance Plan
| Professional | $4,969.00 | $4,998.68 | $4,998.68 | |
Molina
| Professional | $30.00 | $55.00 | $100.00 | |
United
| Professional | $888.93 | $888.93 | $943.15 |