| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.76 | $0.76 | $0.76 | |
Aetna
| Professional | $0.76 | $1.05 | $1.05 | |
Medica
| Facility | $0.76 | $0.83 | $1.77 | |
Medica
| Professional | $54.50 | $65.40 | $109.00 | |
United
| Professional | $43.60 | $65.40 | $109.00 |