| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,128.17 | $2,128.17 | $5,038.68 | |
Aetna
| Professional | $11.16 | $992.51 | $2,128.17 | |
BCBS
| Facility | $434.23 | $1,025.86 | $2,537.00 | |
Medica
| Facility | $100.00 | $2,128.17 | $4,320.18 |