| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.41 | $54.41 | $59.80 | |
Aetna
| Professional | $54.41 | $61.30 | $79.44 | |
Medica
| Facility | $54.41 | $62.53 | $98.08 | |
Medica
| Professional | $67.91 | $81.69 | $334.80 | |
United
| Professional | $67.04 | $77.09 | $117.79 |