| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $33.72 | $33.72 | $10,000.00 | |
Aetna
| Professional | $33.72 | $33.72 | $344.25 | |
Medica
| Facility | $33.72 | $57.32 | $523.73 | |
Medica
| Professional | $52.69 | $94.11 | $129.61 | |
United
| Professional | $60.14 | $100.24 | $366.49 |