| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $26.92 | $40.74 | $48.98 | |
Medica
| Facility | $30.20 | $39.81 | $51.29 | |
Medica
| Professional | $38.90 | $50.12 | $100.00 | |
United
| Facility | $43.65 | $43.65 | $43.65 | |
United
| Professional | $38.90 | $47.86 | $60.26 |