| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.74 | $127.74 | $127.74 | |
Aetna
| Professional | $127.74 | $138.91 | $138.91 | |
BCBS
| Facility | $80.20 | $189.49 | $468.62 | |
BCBS
| Professional | $81.45 | $100.26 | $236.87 | |
Medica
| Facility | $127.74 | $140.51 | $259.31 | |
Medica
| Professional | $138.91 | $138.91 | $138.91 |