| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.63 | $9.63 | $9.63 | |
Aetna
| Professional | $9.44 | $9.63 | $13.72 | |
Medica
| Facility | $9.44 | $9.63 | $14.37 | |
Medica
| Professional | $1.23 | $10.00 | $20.02 | |
United
| Professional | $10.00 | $10.00 | $10.00 |