| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.97 | $24.97 | $24.97 | |
Aetna
| Professional | $24.00 | $24.97 | $36.63 | |
BCBS
| Facility | $1.00 | $1.00 | $1.00 | |
Medica
| Facility | $24.00 | $24.97 | $42.20 | |
Medica
| Professional | $0.90 | $0.90 | $0.90 |