| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,041.74 | $3,981.07 | $4,897.79 | |
Aetna
| Professional | $93.33 | $346.74 | $4,677.35 | |
Health Alliance Plan
| Facility | $2,041.74 | $2,691.53 | $4,897.79 | |
Health Alliance Plan
| Professional | $912.01 | $1,047.13 | $1,318.26 | |
United
| Facility | $2,511.89 | $5,011.87 | $10,232.93 |