| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.32 | $25.32 | $40.57 | |
Aetna
| Professional | $14.68 | $19.50 | $32.34 | |
Medica
| Facility | $24.63 | $25.32 | $36.21 | |
Medica
| Professional | $2.67 | $17.36 | $200.67 | |
United
| Professional | $2.66 | $16.80 | $26.52 |