| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $504.59 | $504.59 | $504.59 | |
Aetna
| Professional | $302.93 | $302.93 | $302.93 | |
BCBS
| Facility | $174.04 | $660.97 | $1,047.06 | |
BCBS
| Professional | $69.58 | $101.20 | $670.58 | |
Medica
| Facility | $100.00 | $333.22 | $433.19 |