| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $278.14 | $278.14 | $278.14 | |
Medica
| Facility | $147.96 | $162.76 | $946.16 | |
Medica
| Professional | $140.27 | $217.85 | $1,172.58 | |
United
| Facility | $200.12 | $200.12 | $200.12 | |
United
| Professional | $137.05 | $211.50 | $275.54 |