| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,073.80 | $4,897.79 | $6,309.57 | |
Aetna
| Professional | $2,238.72 | $2,238.72 | $2,238.72 | |
Health Alliance Plan
| Facility | $4,073.80 | $4,897.79 | $6,309.57 | |
Health Alliance Plan
| Professional | $218.78 | $1,548.82 | $1,659.59 | |
United
| Facility | $4,265.80 | $7,585.78 | $13,803.84 |