| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.11 | $113.27 | $294.51 | |
Aetna
| Professional | $68.65 | $75.52 | $113.27 | |
Medica
| Facility | $67.02 | $76.68 | $192.91 | |
Medica
| Professional | $77.95 | $107.07 | $463.54 | |
United
| Professional | $77.30 | $96.47 | $135.36 |