| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,897.79 | $4,897.79 | $4,897.79 | |
Aetna
| Professional | $263.03 | $3,235.94 | $3,235.94 | |
Health Alliance Plan
| Facility | $707.95 | $2,041.74 | $4,897.79 | |
Health Alliance Plan
| Professional | $707.95 | $812.83 | $1,047.13 | |
United
| Facility | $549.54 | $1,621.81 | $4,073.80 |