| 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 | $23.63 | $23.63 | |
BCBS
| Professional | $19.45 | $22.92 | $23.63 | |
Medica
| Facility | $35.00 | $35.00 | $59.15 | |
Medica
| Professional | $77.00 | $77.00 | $77.00 |