| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.00 | $141.25 | $199.53 | |
Medica
| Facility | $269.15 | $354.81 | $354.81 | |
Medica
| Professional | $147.91 | $186.21 | $436.52 | |
United
| Professional | $134.90 | $169.82 | $204.17 |