| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.68 | $27.68 | $27.68 | |
Aetna
| Professional | $16.82 | $20.62 | $27.68 | |
BCBS
| Professional | $48.29 | $48.29 | $48.29 | |
Medica
| Facility | $18.95 | $24.74 | $43.80 | |
Medica
| Professional | $193.44 | $193.44 | $193.44 | |
United
| Professional | $38.00 | $51.00 | $62.00 |