| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.90 | $39.90 | $39.90 | |
Aetna
| Professional | $32.77 | $39.90 | $39.90 | |
BCBS
| Facility | $57.34 | $87.00 | $152.56 | |
Medica
| Facility | $62.23 | $74.52 | $96.60 | |
Medica
| Professional | $54.87 | $91.08 | $156.78 | |
United
| Professional | $54.87 | $88.26 | $148.40 |