| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.02 | $3.02 | $3.02 | |
Aetna
| Professional | $3.02 | $3.02 | $3.02 | |
BCBS
| Facility | $6,456.54 | $8,511.38 | $16,595.87 | |
BCBS
| Professional | $70.79 | $74.13 | $74.13 | |
Medica
| Facility | $3.09 | $6.61 | $131.83 | |
United
| Facility | $63.10 | $81.28 | $107.15 |