| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.10 | $17.10 | $17.10 | |
Aetna
| Professional | $17.10 | $17.10 | $17.10 | |
BCBS
| Facility | $52.34 | $58.15 | $596.14 | |
BCBS
| Professional | $89.48 | $111.85 | $111.85 | |
Medica
| Facility | $17.10 | $17.10 | $77.67 | |
Medica
| Professional | $282.45 | $282.45 | $282.45 |