| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.00 | $35.00 | $35.00 | |
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
BCBS
| Facility | $1.00 | $17.72 | $17.72 | |
BCBS
| Professional | $14.58 | $17.19 | $17.72 | |
Medica
| Facility | $35.00 | $35.00 | $59.15 | |
Medica
| Professional | $53.27 | $53.27 | $53.27 | |
United
| Professional | $33.20 | $33.20 | $114.91 |