| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $162.18 | $190.55 | $234.42 | |
Medica
| Facility | $234.42 | $245.47 | $1,380.38 | |
Medica
| Professional | $114.82 | $208.93 | $213.80 | |
United
| Professional | $190.55 | $213.80 | $309.03 |