| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.95 | $11.95 | $11.95 | |
Aetna
| Professional | $10.83 | $11.95 | $15.12 | |
BCBS
| Professional | $20.00 | $20.00 | $20.00 | |
Medica
| Facility | $11.95 | $13.62 | $23.57 | |
Medica
| Professional | $14.04 | $24.18 | $283.32 |