| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Health Alliance Plan
| Facility | $5,882.76 | $5,882.76 | $5,882.76 | |
Health Alliance Plan
| Professional | $5,882.76 | $5,882.76 | $7,714.06 | |
United
| Facility | $655.19 | $3,362.00 | $6,501.79 |