| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
BCBS
| Facility | $2.29 | $5.44 | $13.46 | |
BCBS
| Professional | $1.87 | $2.29 | $5.44 | |
Medica
| Facility | $50.00 | $55.00 | $105.80 |