| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5.00 | $5.00 | $5.00 | |
Aetna
| Professional | $5.00 | $5.00 | $5.00 | |
BCBS
| Facility | $1.00 | $1.00 | $1.00 | |
Medica
| Facility | $5.00 | $5.00 | $8.44 | |
Medica
| Professional | $12.47 | $12.47 | $12.47 | |
United
| Professional | $10.80 | $10.80 | $37.38 |