| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.00 | $184.00 | $184.00 | |
BCBS
| Facility | $24.30 | $82.35 | $186.29 | |
BCBS
| Professional | $19.44 | $24.30 | $24.30 | |
Medica
| Facility | $35.57 | $112.04 | $112.04 | |
Medica
| Professional | $10.28 | $15.63 | $51.31 | |
United
| Professional | $10.16 | $14.68 | $51.50 |