| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.67 | $34.67 | $34.67 | |
Aetna
| Professional | $34.67 | $34.67 | $34.67 | |
BCBS
| Facility | $10.23 | $10.72 | $10.72 | |
BCBS
| Professional | $10.72 | $10.72 | $10.72 | |
Medica
| Facility | $34.67 | $34.67 | $47.86 | |
Medica
| Professional | $53.70 | $53.70 | $53.70 |