| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $148.27 | $148.27 | $148.27 | |
Aetna
| Professional | $113.18 | $113.77 | $148.27 | |
BCBS
| Professional | $206.67 | $206.67 | $206.67 | |
Medica
| Facility | $95.98 | $113.77 | $152.44 | |
Medica
| Professional | $738.66 | $738.66 | $738.66 |