| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $64.57 | $64.57 | |
Aetna
| Professional | $64.57 | $64.57 | $158.49 | |
BCBS
| Facility | $6,456.54 | $8,511.38 | $16,595.87 | |
BCBS
| Professional | $75.86 | $79.43 | $79.43 | |
Medica
| Facility | $57.54 | $120.23 | $162.18 | |
United
| Facility | $77.62 | $125.89 | $165.96 |