| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.00 | $65.00 | $65.00 | |
Aetna
| Professional | $26.00 | $26.00 | $65.00 | |
BCBS
| Facility | $157.52 | $372.14 | $920.31 | |
BCBS
| Professional | $140.63 | $173.10 | $408.94 | |
Medica
| Facility | $31.20 | $71.50 | $131.94 |