| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.08 | $2,884.03 | $4,897.79 | |
Aetna
| Professional | $346.74 | $870.96 | $4,365.16 | |
Health Alliance Plan
| Facility | $354.81 | $2,344.23 | $4,897.79 | |
Health Alliance Plan
| Professional | $331.13 | $416.87 | $977.24 | |
United
| Facility | $489.78 | $1,778.28 | $4,073.80 |