| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.83 | $20.83 | $20.83 | |
Aetna
| Professional | $20.83 | $20.83 | $29.28 | |
BCBS
| Facility | $34.33 | $35.03 | $75.78 | |
BCBS
| Professional | $28.02 | $33.97 | $35.03 | |
Medica
| Facility | $20.83 | $20.83 | $57.07 |