| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $838.00 | $3,218.00 | $8,400.00 | |
Aetna
| Facility | 52 | $124.51 | $124.51 | $124.51 |
BCBS
| Facility | $1,114.98 | $1,497.40 | $2,169.03 | |
Medica
| Facility | $239.52 | $356.77 | $4,000.00 | |
Medica
| Facility | 52 | $3,716.72 | $3,716.72 | $3,716.72 |
United
| Facility | $575.00 | $1,928.00 | $4,012.00 |