| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.05 | $68.05 | $68.05 | |
Aetna
| Professional | $42.35 | $51.25 | $68.05 | |
BCBS
| Professional | $84.64 | $84.64 | $84.64 | |
Medica
| Facility | $35.79 | $51.82 | $69.19 | |
Medica
| Professional | $338.50 | $338.50 | $338.50 |