| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.12 | $19.12 | $19.12 | |
Aetna
| Professional | $15.17 | $19.12 | $21.94 | |
BCBS
| Professional | $31.00 | $31.00 | $31.00 | |
Medica
| Facility | $19.12 | $20.23 | $33.35 | |
Medica
| Professional | $20.23 | $33.99 | $283.32 |