| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.78 | $2,041.74 | $4,897.79 | |
Aetna
| Professional | $457.09 | $758.58 | $3,548.13 | |
Health Alliance Plan
| Facility | $173.78 | $2,041.74 | $4,897.79 | |
Health Alliance Plan
| Professional | $457.09 | $562.34 | $3,548.13 | |
United
| Facility | $186.21 | $794.33 | $1,737.80 |