| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $120.23 | $120.23 | |
Health Alliance Plan
| Facility | $120.23 | $120.23 | $120.23 | |
United
| Facility | $158.49 | $165.96 | $169.82 |
Emergency Room-Urgent Care
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $120.23 | $120.23 | |
Health Alliance Plan
| Facility | $120.23 | $120.23 | $120.23 | |
United
| Facility | $158.49 | $165.96 | $169.82 |