| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.28 | $196.28 | $196.28 | |
Aetna
| Professional | $149.83 | $150.65 | $196.28 | |
BCBS
| Professional | $129.88 | $129.88 | $129.88 | |
Medica
| Facility | $81.99 | $150.65 | $201.87 | |
Medica
| Professional | $902.23 | $902.23 | $902.23 |