| 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 | $20.83 | |
BCBS
| Facility | $231.75 | $304.82 | $589.62 | |
Medica
| Facility | $20.83 | $29.28 | $47.60 | |
Medica
| Professional | $272.97 | $272.97 | $272.97 |