| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.83 | $29.83 | $29.83 | |
Aetna
| Professional | $19.12 | $22.36 | $29.83 | |
BCBS
| Professional | $49.62 | $49.62 | $49.62 | |
Medica
| Facility | $20.55 | $26.83 | $44.27 | |
Medica
| Professional | $283.32 | $283.32 | $283.32 |