| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,768.95 | $3,768.95 | $3,768.95 | |
Aetna
| Professional | $3,768.95 | $3,768.95 | $3,768.95 | |
BCBS
| Facility | $0.97 | $1.00 | $1.00 | |
Medica
| Facility | $3,768.95 | $3,768.95 | $6,369.53 |