| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,907.00 | $3,907.00 | $3,907.00 | |
Aetna
| Professional | $66.34 | $100.78 | $130.60 | |
Anthem BCBS
| Professional | $213.23 | $249.33 | $486.32 | |
Medica
| Facility | $66.34 | $100.78 | $413.92 | |
Medica
| Professional | $111.32 | $264.26 | $778.48 | |
United
| Professional | $103.38 | $248.08 | $442.42 |