| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $46.45 | $46.45 | $8,500.00 | |
Aetna
| Professional | $46.45 | $46.45 | $54.55 | |
Medica
| Facility | $36.14 | $46.45 | $139.35 | |
Medica
| Professional | $45.88 | $78.31 | $119.26 | |
United
| Professional | $45.88 | $83.42 | $301.48 |