| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.41 | $18.41 | $18.41 | |
Aetna
| Professional | $18.41 | $18.41 | $18.41 | |
BCBS
| Facility | $17.10 | $18.00 | $18.00 | |
BCBS
| Professional | $17.82 | $17.82 | $17.82 | |
Medica
| Facility | $18.41 | $18.41 | $25.22 |