| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.00 | $64.00 | $64.00 | |
Aetna
| Professional | $64.00 | $64.00 | $64.00 | |
BCBS
| Facility | $6,526.36 | $8,583.94 | $16,604.12 | |
Medica
| Facility | $57.60 | $120.20 | $160.86 | |
Midlands
| Facility | $132.54 | $159.32 | $232.71 |