| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.38 | $20.38 | $20.38 | |
Aetna
| Professional | $20.38 | $20.38 | $21.15 | |
Anthem BCBS
| Professional | $10.50 | $10.50 | $12.92 | |
Medica
| Facility | $20.38 | $24.92 | $55.64 | |
Medica
| Professional | $96.82 | $96.82 | $96.82 |