| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $193.39 | $193.39 | $229.00 | |
Aetna
| Professional | $178.41 | $193.39 | $196.50 | |
Medica
| Facility | $189.21 | $297.70 | $873.48 | |
Medica
| Professional | $224.71 | $367.70 | $634.88 | |
United
| Professional | $208.24 | $362.85 | $634.88 |