| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.26 | $23.26 | $23.26 | |
Aetna
| Professional | $17.04 | $17.47 | $23.26 | |
BCBS
| Professional | $55.54 | $62.94 | $74.05 | |
Medica
| Facility | $17.04 | $23.26 | $39.54 | |
Medica
| Professional | $38.77 | $119.84 | $119.84 |