| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.13 | $14.13 | $14.13 | |
Aetna
| Professional | $14.13 | $14.13 | $144.54 | |
BCBS
| Facility | $6,456.54 | $8,511.38 | $16,595.87 | |
BCBS
| Professional | $72.44 | $75.86 | $75.86 | |
Medica
| Facility | $13.49 | $28.18 | $114.82 | |
United
| Facility | $56.23 | $112.20 | $147.91 |