| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.28 | $58.28 | $109.40 | |
BCBS
| Facility | $96.00 | $376.92 | $628.08 | |
BCBS
| Professional | $80.40 | $96.00 | $111.60 | |
Medica
| Facility | $58.28 | $109.40 | $156.44 | |
Medica
| Professional | $178.61 | $178.61 | $178.61 |