| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.06 | $80.06 | $80.06 | |
Aetna
| Professional | $80.06 | $80.06 | $80.06 | |
BCBS
| Professional | $144.49 | $170.25 | $186.34 | |
Medica
| Facility | $80.06 | $80.06 | $148.11 | |
United
| Professional | $45.80 | $45.80 | $45.80 |