| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.84 | $2.27 | $2.27 | |
Aetna
| Professional | $1.05 | $1.05 | $1.05 | |
Hally Health
| Professional | $1.48 | $1.70 | $150.00 | |
Medica
| Facility | $1.61 | $1.62 | $1.77 | |
Medica
| Professional | $65.40 | $65.40 | $139.52 | |
United
| Professional | $65.40 | $65.40 | $109.00 |