| 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 | $1.00 | $2.02 | $4.36 | |
BCBS
| Professional | $1.62 | $1.96 | $2.02 | |
Medica
| Facility | $50.00 | $100.00 | $100.00 |