| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.95 | $19.95 | $19.95 | |
Aetna
| Professional | $19.95 | $19.95 | $28.84 | |
BCBS
| Facility | $234.42 | $302.00 | $588.84 | |
Medica
| Facility | $20.89 | $29.51 | $39.81 | |
Medica
| Professional | $275.42 | $275.42 | $275.42 |