| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.38 | $9.38 | $9.38 | |
Aetna
| Professional | $4.83 | $9.38 | $22.72 | |
BCBS
| Facility | $58.57 | $65.44 | $107.01 | |
BCBS
| Professional | $52.35 | $62.32 | $65.44 | |
Medica
| Facility | $4.97 | $11.33 | $885.11 |