| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.80 | $78.80 | $78.80 | |
Aetna
| Professional | $44.58 | $78.80 | $78.80 | |
BCBS
| Facility | $57.34 | $87.00 | $152.56 | |
Medica
| Facility | $29.35 | $122.85 | $133.16 | |
Medica
| Professional | $56.45 | $93.80 | $162.04 | |
United
| Professional | $64.95 | $104.59 | $163.29 |