| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.70 | $32.36 | $43.65 | |
Medica
| Facility | $25.70 | $30.90 | $44.67 | |
Medica
| Professional | $20.42 | $26.92 | $52.48 | |
United
| Facility | $19.05 | $19.05 | $19.05 | |
United
| Professional | $19.95 | $25.12 | $35.48 |