| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.00 | $1.00 | |
Aetna
| Professional | $1.00 | $1.00 | $2.00 | |
Medica
| Facility | $1.32 | $2.04 | $2.63 | |
Medica
| Professional | $2.04 | $2.04 | $11.75 | |
United
| Professional | $3.31 | $3.31 | $3.31 |