| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.00 | $10.00 | $10.00 | |
Aetna
| Professional | $10.00 | $10.00 | $10.00 | |
BCBS
| Facility | $2.82 | $2.95 | $2.95 | |
BCBS
| Professional | $2.88 | $2.88 | $2.88 | |
Medica
| Facility | $10.00 | $10.00 | $13.80 | |
Medica
| Professional | $28.84 | $28.84 | $28.84 |