| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.91 | $138.91 | $138.91 | |
Aetna
| Professional | $138.91 | $138.91 | $138.91 | |
BCBS
| Facility | $1.00 | $38.22 | $3,138.92 | |
BCBS
| Professional | $30.58 | $37.07 | $38.22 | |
Medica
| Facility | $127.74 | $138.91 | $234.77 |