| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $47.02 | $51.72 | $70.53 | |
Aetna
| Professional | $47.02 | $47.02 | $47.02 | |
Medica
| Facility | $45.56 | $47.02 | $2,489.36 | |
Medica
| Professional | $53.53 | $71.81 | $372.64 | |
United
| Professional | $53.07 | $64.73 | $106.77 |