| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.48 | $63.10 | $63.10 | |
Aetna
| Professional | $33.88 | $50.12 | $63.10 | |
Anthem BCBS
| Professional | $33.88 | $42.66 | $63.10 | |
BCBS
| Professional | $61.66 | $81.28 | $81.28 | |
Medica
| Facility | $41.69 | $63.10 | $173.78 | |
Medica
| Professional | $338.84 | $338.84 | $338.84 |