| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.68 | $28.52 | $28.52 | |
Anthem BCBS
| Professional | $2.00 | $4.00 | $4.00 | |
Medica
| Facility | $28.52 | $31.66 | $63.44 | |
Medica
| Professional | $1,975.05 | $1,975.05 | $1,975.05 |