| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.36 | $0.36 | $0.72 | |
Aetna
| Professional | $0.36 | $0.36 | $0.36 | |
Medica
| Facility | $0.36 | $4.30 | $95.00 | |
Medica
| Professional | $4.25 | $4.25 | $4.25 | |
United
| Professional | $4.25 | $4.25 | $4.25 |