| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.21 | $9.21 | $12.05 | |
Aetna
| Professional | $6.91 | $9.21 | $12.05 | |
Medica
| Facility | $9.21 | $13.74 | $17.98 | |
Medica
| Professional | $14.40 | $14.40 | $15.89 | |
United
| Professional | $14.40 | $14.40 | $16.13 |