| 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 | $13.67 | $14.39 | $14.39 | |
BCBS
| Professional | $14.25 | $14.25 | $14.25 | |
Medica
| Facility | $35.00 | $35.00 | $46.90 | |
Medica
| Professional | $77.00 | $77.00 | $77.00 |