| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.00 | $70.00 | $70.00 | |
Aetna
| Professional | $70.00 | $70.00 | $70.00 | |
BCBS
| Professional | $43.00 | $51.82 | $60.64 | |
Medica
| Facility | $70.00 | $73.50 | $77.00 | |
Medica
| Professional | $31.85 | $259.38 | $259.38 |