| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
BCBS
| Facility | $98.67 | $101.20 | $126.50 | |
BCBS
| Professional | $75.90 | $101.20 | $168.25 | |
Medica
| Facility | $25.00 | $25.00 | $27.50 | |
Medica
| Professional | $25.00 | $25.00 | $25.00 |