| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.70 | $26.92 | $26.92 | |
Aetna
| Professional | $23.99 | $23.99 | $25.70 | |
Medica
| Facility | $26.92 | $29.51 | $102.33 | |
Medica
| Professional | $28.18 | $32.36 | $35.48 | |
United
| Professional | $28.18 | $33.11 | $35.48 |