| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.64 | $19.64 | $39.10 | |
Aetna
| Professional | $19.64 | $19.64 | $19.64 | |
BCBS
| Facility | $29.49 | $42.74 | $59.50 | |
Medica
| Facility | $19.64 | $24.26 | $90.98 | |
Medica
| Professional | $19.64 | $19.64 | $19.64 | |
United
| Professional | $19.64 | $19.64 | $19.64 |