| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.42 | $57.42 | $57.42 | |
Aetna
| Professional | $57.42 | $63.10 | $67.37 | |
BCBS
| Professional | $81.13 | $81.13 | $81.13 | |
Medica
| Facility | $55.59 | $64.84 | $182.20 | |
Medica
| Professional | $69.42 | $85.08 | $432.44 | |
United
| Professional | $68.06 | $78.27 | $110.43 |