| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $103.24 | $103.24 | $103.24 | |
BCBS
| Professional | $148.00 | $148.00 | $148.00 | |
Medica
| Facility | $53.92 | $64.76 | $96.94 | |
Medica
| Professional | $56.81 | $68.80 | $129.40 | |
United
| Professional | $53.64 | $64.95 | $92.46 |