| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,230.27 | $3,090.30 | $6,456.54 | |
Aetna
| Facility | 50 | $7,079.46 | $7,079.46 | $7,079.46 |
BCBS
| Facility | $186.21 | $602.56 | $912.01 | |
Medica
| Facility | $194.98 | $912.01 | $2,570.40 | |
United
| Facility | $954.99 | $1,698.24 | $3,235.94 |