| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $48.70 | $59.02 | $66.41 | |
Aetna
| Professional | $37.31 | $59.02 | $69.97 | |
Medica
| Facility | $44.27 | $59.02 | $99.54 | |
Medica
| Professional | $58.90 | $79.68 | $334.80 | |
United
| Professional | $58.90 | $72.76 | $103.69 |