| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $405.00 | $19,731.50 | $19,731.50 | |
BCBS
| Facility | $118.03 | $118.03 | $367.68 | |
Medica
| Facility | $91.50 | $179.34 | $1,924.00 | |
United
| Facility | $631.00 | $1,488.00 | $2,175.00 |