| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.89 | $94.89 | $94.89 | |
Aetna
| Professional | $94.89 | $107.21 | $107.21 | |
BCBS
| Professional | $179.70 | $179.70 | $179.70 | |
Medica
| Facility | $107.21 | $403.00 | $1,661.00 | |
Medica
| Professional | $175.13 | $341.18 | $746.58 | |
United
| Facility | $191.00 | $550.00 | $1,769.00 | |
United
| Professional | $159.21 | $316.81 | $428.91 |