| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.52 | $28.52 | $28.52 | |
Aetna
| Professional | $11.68 | $28.52 | $41.51 | |
BCBS
| Facility | $1.00 | $1.00 | $1.00 | |
Medica
| Facility | $19.66 | $28.52 | $48.20 | |
Medica
| Professional | $1,975.05 | $1,975.05 | $1,975.05 |