| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $16.98 | $16.98 | $16.98 | |
BCBS
| Facility | $95.50 | $269.15 | $467.74 | |
BCBS
| Professional | $83.18 | $107.15 | $173.78 | |
Medica
| Facility | $16.98 | $77.62 | $112.20 | |
Medica
| Professional | $281.84 | $281.84 | $281.84 | |
United
| Facility | $38.90 | $38.90 | $38.90 |