| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $34.82 | $34.82 | $34.82 | |
Aetna
| Professional | $23.96 | $30.04 | $34.82 | |
BCBS
| Professional | $49.15 | $50.03 | $58.54 | |
Medica
| Facility | $33.02 | $42.47 | $63.12 | |
Medica
| Professional | $66.50 | $283.32 | $283.32 |