| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4.88 | $4.88 | $4.88 | |
Aetna
| Professional | $4.88 | $4.88 | $4.88 | |
BCBS
| Facility | $12.29 | $12.94 | $12.94 | |
BCBS
| Professional | $12.81 | $12.81 | $12.81 | |
Medica
| Facility | $4.88 | $4.88 | $7.28 | |
Medica
| Professional | $7.70 | $7.70 | $7.70 |