| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,361.80 | $2,200.00 | $2,200.00 | |
BCBS
| Facility | $3,222.53 | $12,238.21 | $19,387.05 | |
BCBS
| Professional | $4,273.92 | $5,698.56 | $27,602.40 | |
Medica
| Facility | $100.00 | $100.00 | $1,361.80 |