| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.80 | $0.80 | $0.80 | |
Aetna
| Professional | $0.80 | $0.80 | $0.80 | |
Anthem BCBS
| Professional | $59.00 | $59.00 | $406.01 | |
Medica
| Facility | $0.80 | $1.22 | $99.00 | |
Medica
| Professional | $2.39 | $2.39 | $26.11 |