| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $758.58 | $4,897.79 | $4,897.79 | |
Aetna
| Professional | $234.42 | $537.03 | $8,709.64 | |
Health Alliance Plan
| Facility | $758.58 | $4,897.79 | $6,918.31 | |
Health Alliance Plan
| Professional | $467.74 | $501.19 | $1,778.28 | |
United
| Facility | $645.65 | $1,778.28 | $4,073.80 |