| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.17 | $2,056.00 | $4,933.00 | |
Aetna
| Professional | $58.98 | $74.17 | $85.13 | |
Health Alliance Plan
| Facility | $74.17 | $2,056.00 | $4,933.00 | |
Health Alliance Plan
| Professional | $58.98 | $74.17 | $74.26 | |
United
| Facility | $300.00 | $1,418.00 | $2,029.00 | |
United
| Professional | $80.09 | $101.05 | $129.54 |