| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $143.01 | $143.01 | $284.58 | |
Aetna
| Professional | $143.01 | $143.01 | $143.01 | |
Medica
| Facility | $136.80 | $150.16 | $176.55 | |
Medica
| Professional | $136.80 | $136.80 | $136.80 | |
United
| Professional | $136.80 | $136.80 | $136.80 |