| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,041.74 | $2,041.74 | $4,897.79 | |
Aetna
| Professional | $128.82 | $165.96 | $213.80 | |
Health Alliance Plan
| Facility | $208.93 | $2,041.74 | $4,897.79 | |
Health Alliance Plan
| Professional | $165.96 | $199.53 | $263.03 | |
United
| Facility | $851.14 | $3,890.45 | $6,025.60 | |
United
| Professional | $177.83 | $213.80 | $288.40 |