| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $210.00 | $229.00 | $318.00 | |
Aetna
| Professional | $398.00 | $398.00 | $398.00 | |
BCBS
| Facility | $1,289.64 | $2,222.65 | $3,909.22 | |
Medica
| Facility | $2,291.79 | $2,462.34 | $3,144.55 |