| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.65 | $40.65 | $40.65 | |
Aetna
| Professional | $40.65 | $40.65 | $70.11 | |
BCBS
| Professional | $145.40 | $174.82 | $191.67 | |
Medica
| Facility | $40.65 | $69.11 | $121.95 | |
Medica
| Professional | $63.67 | $108.68 | $139.50 | |
United
| Professional | $65.25 | $120.86 | $139.50 |