| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.04 | $194.98 | $338.84 | |
Aetna
| Professional | $138.04 | $186.21 | $229.09 | |
Medica
| Facility | $138.04 | $234.42 | $870.96 | |
Medica
| Professional | $181.97 | $263.03 | $407.38 | |
United
| Professional | $181.97 | $245.47 | $407.38 |