| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.69 | $41.69 | $41.69 | |
Aetna
| Professional | $37.15 | $42.66 | $60.26 | |
BCBS
| Professional | $104.71 | $104.71 | $104.71 | |
Medica
| Facility | $42.66 | $51.29 | $64.57 | |
Medica
| Professional | $302.00 | $302.00 | $302.00 |