| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.39 | $40.39 | $80.38 | |
Aetna
| Professional | $40.39 | $40.39 | $40.39 | |
BCBS
| Facility | $0.20 | $0.32 | $0.51 | |
Medica
| Facility | $40.39 | $47.37 | $4,977.24 | |
Medica
| Professional | $42.28 | $42.28 | $42.28 | |
United
| Professional | $42.28 | $42.28 | $42.28 |