| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.45 | $7.45 | $16.76 | |
Aetna
| Professional | $7.45 | $9.31 | $9.31 | |
Medica
| Facility | $7.45 | $8.15 | $90.00 | |
Medica
| Professional | $3.98 | $9.94 | $11.73 | |
United
| Facility | $0.12 | $0.12 | $0.12 | |
United
| Professional | $3.91 | $9.77 | $10.93 |