| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.72 | $131.72 | $131.72 | |
Aetna
| Professional | $106.45 | $131.72 | $137.50 | |
Health Partners
| Professional | $162.03 | $162.03 | $162.03 | |
Medica
| Facility | $91.90 | $131.72 | $222.61 |