| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.36 | $58.36 | $58.36 | |
Aetna
| Professional | $47.28 | $58.36 | $58.36 | |
BCBS
| Facility | $99.21 | $182.33 | $211.16 | |
BCBS
| Professional | $161.53 | $196.27 | $196.27 | |
Medica
| Facility | $46.40 | $85.00 | $120.46 | |
Medica
| Professional | $338.50 | $338.50 | $338.50 |