| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.82 | $92.82 | $92.82 | |
Aetna
| Professional | $70.84 | $71.29 | $92.82 | |
BCBS
| Professional | $124.16 | $124.16 | $124.16 | |
Medica
| Facility | $56.22 | $71.29 | $95.53 | |
Medica
| Professional | $621.45 | $621.45 | $621.45 |