| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.79 | $70.79 | $70.79 | |
Aetna
| Professional | $70.79 | $70.79 | $120.23 | |
BCBS
| Professional | $151.36 | $151.36 | $151.36 | |
Medica
| Facility | $70.79 | $70.79 | $93.33 | |
Medica
| Professional | $257.04 | $257.04 | $257.04 |