| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.61 | $94.61 | $94.61 | |
Aetna
| Professional | $94.60 | $94.61 | $111.55 | |
BCBS
| Professional | $148.00 | $148.00 | $148.00 | |
Medica
| Facility | $88.50 | $100.51 | $151.38 | |
Medica
| Professional | $90.61 | $171.48 | $728.46 |