| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.67 | $34.67 | $34.67 | |
Aetna
| Professional | $34.67 | $34.67 | $34.67 | |
BCBS
| Facility | $35.48 | $35.48 | $35.48 | |
BCBS
| Professional | $28.18 | $35.48 | $35.48 | |
Medica
| Facility | $34.67 | $34.67 | $58.88 | |
Medica
| Professional | $64.57 | $64.57 | $64.57 | |
United
| Professional | $20.42 | $31.62 | $109.65 |