| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $61.66 | $67.61 | $67.61 | |
Aetna
| Professional | $52.48 | $64.57 | $70.79 | |
Medica
| Facility | $64.57 | $100.00 | $117.49 | |
Medica
| Professional | $67.61 | $93.33 | $436.52 | |
Midlands
| Professional | $81.28 | $81.28 | $91.20 | |
United
| Professional | $69.18 | $91.20 | $147.91 |