| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.68 | $52.68 | $52.68 | |
Aetna
| Professional | $39.25 | $50.10 | $52.68 | |
BCBS
| Professional | $115.41 | $117.48 | $137.47 | |
Medica
| Facility | $48.75 | $70.86 | $96.07 | |
Medica
| Professional | $97.55 | $314.82 | $314.82 |