| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.56 | $34.56 | $37.97 | |
Aetna
| Professional | $34.56 | $38.95 | $50.47 | |
Medica
| Facility | $37.97 | $43.45 | $109.45 | |
Medica
| Professional | $43.03 | $51.12 | $262.88 | |
United
| Professional | $42.56 | $45.05 | $74.84 |