| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
BCBS
| Facility | $4.00 | $6.80 | $6.80 | |
BCBS
| Professional | $3.50 | $4.00 | $4.65 | |
Medica
| Facility | $10.00 | $10.00 | $16.10 | |
Medica
| Professional | $29.12 | $29.12 | $29.12 |