| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.99 | $35.99 | $35.99 | |
Aetna
| Professional | $24.63 | $26.96 | $35.99 | |
BCBS
| Professional | $74.42 | $74.42 | $74.42 | |
Medica
| Facility | $27.48 | $35.99 | $55.40 | |
Medica
| Professional | $283.32 | $283.32 | $283.32 |