| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $297.06 | $297.06 | $297.06 | |
BCBS
| Facility | $20.36 | $28.96 | $39.71 | |
BCBS
| Professional | $743.11 | $743.11 | $743.11 | |
Medica
| Facility | $297.06 | $297.06 | $297.06 | |
Medica
| Professional | $387.71 | $387.71 | $666.86 | |
Midlands
| Professional | $633.69 | $633.69 | $679.04 | |
United
| Professional | $387.71 | $387.71 | $666.86 |