| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.67 | $251.82 | $654.74 | |
Aetna
| Professional | $152.62 | $167.88 | $251.82 | |
Medica
| Facility | $148.84 | $173.76 | $1,150.82 | |
Medica
| Professional | $172.51 | $236.96 | $6,299.47 | |
United
| Professional | $172.51 | $220.00 | $462.39 |