| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.60 | $45.60 | $45.60 | |
Aetna
| Professional | $45.60 | $45.60 | $60.00 | |
BCBS
| Facility | $1,739.54 | $1,897.92 | $2,013.11 | |
BCBS
| Professional | $1,883.84 | $1,883.84 | $1,883.84 | |
Medica
| Facility | $45.60 | $45.60 | $60.00 | |
Medica
| Professional | $57.00 | $57.00 | $57.00 |