| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $38.59 | $38.59 | $38.59 | |
Aetna
| Professional | $18.19 | $38.59 | $71.25 | |
BCBS
| Professional | $40.79 | $46.24 | $54.41 | |
Medica
| Facility | $38.59 | $65.59 | $121.77 | |
Medica
| Professional | $40.45 | $382.72 | $382.72 |