| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $15.14 | $23.99 | $28.84 | |
Medica
| Facility | $18.20 | $23.44 | $33.88 | |
Medica
| Professional | $25.70 | $32.36 | $66.07 | |
United
| Facility | $28.84 | $28.84 | $28.84 | |
United
| Professional | $25.70 | $30.20 | $38.90 |