| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,671.00 | $3,617.00 | $6,329.00 | |
BCBS
| Facility | $903.06 | $3,321.60 | $5,432.89 | |
Medica
| Facility | $872.55 | $1,424.00 | $4,337.00 | |
Medica
| Facility | AS | $206.63 | $206.63 | $381.48 |
United
| Facility | $1,424.00 | $3,269.00 | $6,416.00 |