| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
BCBS
| Facility | $63.20 | $107.44 | $107.44 | |
BCBS
| Professional | $55.30 | $63.20 | $73.47 | |
Medica
| Facility | $35.00 | $35.00 | $56.35 | |
Medica
| Professional | $64.70 | $64.70 | $64.70 |