| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,041.74 | $2,884.03 | $4,897.79 | |
Aetna
| Professional | $794.33 | $794.33 | $3,630.78 | |
Health Alliance Plan
| Facility | $346.74 | $2,041.74 | $4,897.79 | |
Health Alliance Plan
| Professional | $138.04 | $169.82 | $213.80 | |
United
| Facility | $181.97 | $831.76 | $1,862.09 |