| 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 | $0.97 | $1.00 | $129.49 | |
BCBS
| Professional | $103.59 | $125.61 | $129.49 | |
Medica
| Facility | $50.00 | $50.00 | $90.00 |