| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.06 | $60.06 | $60.06 | |
Aetna
| Professional | $38.79 | $45.03 | $60.06 | |
BCBS
| Professional | $107.93 | $107.93 | $107.93 | |
Medica
| Facility | $45.03 | $52.78 | $83.76 | |
Medica
| Professional | $314.82 | $314.82 | $314.82 |