| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $367.50 | $420.00 | |
Aetna
| Professional | $40.00 | $41.00 | $354.55 | |
Medica
| Facility | $40.00 | $40.00 | $42.00 | |
Medica
| Professional | $47.00 | $52.00 | $1,576.96 | |
United
| Professional | $47.00 | $50.00 | $62.00 |