| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.38 | $77.56 | $91.47 | |
Medica
| Facility | $256.79 | $256.79 | $4,467.31 | |
Medica
| Professional | $144.82 | $170.37 | $170.37 | |
United
| Professional | $93.83 | $138.11 | $228.45 |