| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.31 | $13.31 | $16.64 | |
Aetna
| Professional | $13.31 | $13.31 | $16.64 | |
BCBS
| Facility | $14.92 | $17.55 | $20.35 | |
BCBS
| Professional | $14.75 | $14.75 | $14.75 | |
Medica
| Facility | $13.31 | $16.64 | $100.00 |