| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.95 | $84.95 | $84.95 | |
Aetna
| Professional | $84.19 | $84.95 | $84.95 | |
Medica
| Facility | $84.95 | $131.66 | $161.41 | |
Medica
| Professional | $451.00 | $451.00 | $451.00 | |
Midlands
| Professional | $332.85 | $345.32 | $345.32 | |
Oscar Health
| Professional | $230.50 | $230.50 | $230.50 | |
United
| Facility | $233.00 | $233.00 | $233.00 |