| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.91 | $36.31 | $39.81 | |
Medica
| Facility | $26.92 | $36.31 | $39.81 | |
Medica
| Professional | $31.62 | $39.81 | $74.13 | |
United
| Facility | $33.88 | $33.88 | $33.88 | |
United
| Professional | $30.90 | $39.81 | $56.23 |