| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $236.32 | $236.32 | $236.32 | |
Aetna
| Professional | $236.32 | $236.32 | $239.10 | |
Medica
| Facility | $236.32 | $251.06 | $528.89 | |
Medica
| Professional | $269.14 | $568.41 | $1,819.54 |