| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.91 | $17.91 | $17.91 | |
Aetna
| Professional | $11.95 | $13.48 | $17.91 | |
BCBS
| Professional | $31.53 | $31.53 | $31.53 | |
Medica
| Facility | $13.48 | $15.50 | $25.07 | |
Medica
| Professional | $283.32 | $283.32 | $283.32 |