| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $16.98 | $16.98 | |
Aetna
| Professional | $16.98 | $16.98 | $16.98 | |
Anthem BCBS
| Professional | $30.20 | $30.20 | $30.20 | |
Medica
| Facility | $16.98 | $18.62 | $45.71 | |
Medica
| Professional | $281.84 | $281.84 | $281.84 | |
United
| Facility | $38.90 | $38.90 | $165.96 |