| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.97 | $24.97 | $24.97 | |
Aetna
| Professional | $24.97 | $24.97 | $24.97 | |
BCBS
| Facility | $59.57 | $62.71 | $62.71 | |
BCBS
| Professional | $62.09 | $62.09 | $62.09 | |
Medica
| Facility | $24.97 | $24.97 | $36.43 | |
Medica
| Professional | $0.90 | $0.90 | $0.90 |