| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $6.00 | $6.00 | $6.00 | |
BCBS
| Facility | $38.40 | $65.28 | $65.28 | |
BCBS
| Professional | $42.00 | $48.00 | $55.80 | |
Medica
| Facility | $6.00 | $6.00 | $9.66 | |
Medica
| Professional | $16.20 | $16.20 | $16.20 |