| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.00 | $330.00 | $330.00 | |
Aetna
| Professional | $35.00 | $50.00 | $360.00 | |
Medica
| Facility | $84.50 | $84.50 | $3,700.00 | |
Medica
| Professional | $50.00 | $65.00 | $110.00 | |
United
| Professional | $50.00 | $65.00 | $90.00 | |
Wellmark
| Professional | $304.20 | $384.00 | $399.00 |