| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,933.00 | $6,853.00 | $6,853.00 | |
Aetna
| Professional | $9,939.00 | $13,753.37 | $17,229.00 | |
Health Alliance Plan
| Facility | $4,933.00 | $6,853.00 | $6,853.00 | |
Health Alliance Plan
| Professional | $4,933.00 | $6,853.00 | $9,939.00 | |
United
| Facility | $3,296.00 | $6,978.00 | $8,911.00 |