| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.02 | $96.02 | $96.02 | |
Aetna
| Professional | $96.02 | $96.02 | $103.40 | |
Medica
| Facility | $86.42 | $470.81 | $1,582.00 | |
Medica
| Professional | $131.72 | $175.57 | $746.58 | |
United
| Facility | $100.00 | $610.00 | $1,883.00 | |
United
| Professional | $132.13 | $179.97 | $292.47 |