| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $660.98 | $660.98 | $5,868.77 | |
Aetna
| Professional | $660.98 | $660.98 | $660.98 | |
BCBS
| Facility | $24.38 | $63.84 | $200.57 | |
BCBS
| Professional | $36.00 | $44.31 | $104.69 | |
Medica
| Facility | $660.98 | $727.08 | $1,398.61 |