| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $229.00 | $260.01 | $260.01 | |
Aetna
| Professional | $260.01 | $260.01 | $260.01 | |
BCBS
| Facility | $893.20 | $13,277.30 | $27,674.38 | |
BCBS
| Professional | $261.08 | $326.35 | $326.35 | |
Medica
| Facility | $260.01 | $370.88 | $19,803.72 |