| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.54 | $371.54 | $645.65 | |
Aetna
| Professional | $371.54 | $371.54 | $380.19 | |
Medica
| Facility | $524.81 | $616.60 | $1,047.13 | |
Wellmark
| Professional | $7,585.78 | $7,585.78 | $7,585.78 |