| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.14 | $5.14 | $5.14 | |
Aetna
| Professional | $1.00 | $5.14 | $5.14 | |
BCBS
| Facility | $1.00 | $1.00 | $1.00 | |
Medica
| Facility | $4.40 | $5.14 | $8.69 | |
Medica
| Professional | $5.79 | $5.79 | $5.79 | |
United
| Professional | $5.00 | $5.00 | $17.30 |