| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
BCBS
| Facility | $0.95 | $1.00 | $1.00 | |
BCBS
| Professional | $186.01 | $347.56 | $490.69 | |
Medica
| Facility | $3.00 | $100.00 | $100.00 |