| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
BCBS
| Facility | $38.72 | $65.81 | $65.81 | |
BCBS
| Professional | $42.35 | $48.40 | $56.27 | |
Medica
| Facility | $5.00 | $5.00 | $8.05 | |
Medica
| Professional | $12.47 | $12.47 | $12.47 |