| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.47 | $21.47 | $21.47 | |
Aetna
| Professional | $18.55 | $21.47 | $24.88 | |
BCBS
| Professional | $73.41 | $74.73 | $87.45 | |
Medica
| Facility | $19.30 | $34.47 | $42.93 | |
Medica
| Professional | $35.47 | $283.32 | $283.32 |