| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
BCBS
| Facility | $2.94 | $5.00 | $5.00 | |
BCBS
| Professional | $3.22 | $3.68 | $4.28 | |
Medica
| Facility | $5.00 | $5.00 | $8.05 | |
Medica
| Professional | $31.11 | $31.11 | $31.11 |