| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $517.29 | $517.29 | $517.29 | |
Aetna
| Professional | $517.29 | $517.29 | $605.00 | |
BCBS
| Facility | $107.78 | $331.55 | $607.04 | |
BCBS
| Professional | $267.33 | $334.16 | $334.16 | |
Medica
| Facility | $443.94 | $550.00 | $874.24 |