| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,897.79 | $5,248.07 | $5,754.40 | |
Aetna
| Professional | $630.96 | $3,715.35 | $5,128.61 | |
Health Alliance Plan
| Facility | $2,511.89 | $4,897.79 | $5,754.40 | |
Health Alliance Plan
| Professional | $1,000.00 | $1,230.27 | $1,819.70 | |
United
| Facility | $4,265.80 | $7,585.78 | $13,803.84 |