| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.00 | $88.00 | $88.00 | |
Aetna
| Professional | $88.00 | $88.00 | $88.00 | |
BCBS
| Facility | $6,526.36 | $8,583.94 | $16,604.12 | |
Medica
| Facility | $79.20 | $134.27 | $179.69 | |
Midlands
| Facility | $160.88 | $190.14 | $259.94 |