| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $39.81 | $39.81 | $39.81 | |
BCBS
| Facility | $15.49 | $35.48 | $74.13 | |
BCBS
| Professional | $45.71 | $60.26 | $112.20 | |
Medica
| Facility | $39.81 | $39.81 | $85.11 | |
Medica
| Professional | $39.81 | $39.81 | $39.81 | |
United
| Facility | $229.09 | $229.09 | $229.09 |