| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $800.00 | $2,992.00 | $8,400.00 | |
Aetna
| Facility | 52 | $105.40 | $105.40 | $255.93 |
BCBS
| Facility | $2,659.22 | $4,194.93 | $6,674.72 | |
Medica
| Facility | $217.55 | $573.66 | $5,849.00 | |
Medica
| Facility | 52 | $664.86 | $664.86 | $664.86 |
United
| Facility | $1,091.00 | $4,054.00 | $7,077.94 |