| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.78 | $84.95 | $84.95 | |
Ambetter
| Professional | $40.00 | $40.00 | $40.50 | |
BCBS
| Professional | $164.00 | $164.00 | $164.00 | |
Medica
| Facility | $75.81 | $84.95 | $96.84 | |
Medica
| Professional | $451.00 | $451.00 | $451.00 | |
United
| Facility | $233.00 | $233.00 | $233.00 |