| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
BCBS
| Facility | $0.95 | $1.00 | $1.00 | |
Medica
| Facility | $1.26 | $1.26 | $2.27 | |
Medica
| Professional | $77.70 | $77.70 | $77.70 |