| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $344.00 | $344.00 | $344.00 | |
Aetna
| Professional | $344.00 | $344.00 | $344.00 | |
BCBS
| Facility | $138.47 | $327.16 | $809.07 | |
BCBS
| Professional | $140.63 | $173.10 | $408.94 | |
Medica
| Facility | $344.00 | $378.40 | $727.89 |