| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.71 | $94.71 | $94.71 | |
Aetna
| Professional | $6.04 | $27.73 | $35.92 | |
BCBS
| Facility | $25.46 | $96.68 | $153.15 | |
BCBS
| Professional | $29.64 | $30.40 | $60.61 | |
Medica
| Facility | $27.73 | $35.92 | $76.01 |