| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.69 | $7.69 | $15.30 | |
Aetna
| Professional | $7.69 | $7.69 | $7.69 | |
Medica
| Facility | $7.69 | $8.46 | $11.00 | |
Medica
| Professional | $9.49 | $9.49 | $9.49 | |
United
| Professional | $9.49 | $9.49 | $9.49 |