| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,380.38 | $2,041.74 | $2,454.71 | |
Molina
| Facility | $5,248.07 | $8,912.51 | $14,454.40 | |
Optum
| Facility | $912.01 | $1,071.52 | $1,905.46 | |
United
| Facility | $912.01 | $1,778.28 | $39,810.72 |