| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,570.40 | $2,570.40 | $2,570.40 | |
Molina
| Facility | $1,071.52 | $1,174.90 | $2,398.83 | |
Quartz
| Facility | $100.00 | $13,803.84 | $13,803.84 | |
Security Health
| Facility | $2,570.40 | $2,570.40 | $3,019.95 |