| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.06 | $88.06 | $88.06 | |
Aetna
| Professional | $88.06 | $88.06 | $89.09 | |
BCBS
| Professional | $142.00 | $142.00 | $142.00 | |
Medica
| Facility | $86.94 | $93.54 | $148.97 | |
Medica
| Professional | $91.69 | $160.11 | $677.88 |