| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $74.33 | $74.33 | $74.33 | |
Aetna
| Professional | $56.74 | $57.03 | $74.33 | |
BCBS
| Professional | $101.77 | $101.77 | $101.77 | |
Medica
| Facility | $38.70 | $57.03 | $92.88 | |
Medica
| Professional | $352.42 | $352.42 | $352.42 |