| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $114.82 | $114.82 | |
Aetna
| Professional | $114.82 | $120.23 | $123.03 | |
BCBS
| Facility | $2,398.83 | $3,162.28 | $6,165.95 | |
Medica
| Facility | $114.82 | $173.78 | $218.78 | |
Medica
| Professional | $316.23 | $316.23 | $316.23 |