| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $64.57 | $64.57 | |
Aetna
| Professional | $64.57 | $64.57 | $72.44 | |
BCBS
| Facility | $257.04 | $269.15 | $363.08 | |
Medica
| Facility | $66.07 | $66.07 | $128.82 | |
Medica
| Professional | $218.78 | $218.78 | $218.78 |