| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.00 | $116.00 | $116.00 | |
Aetna
| Professional | $116.00 | $116.00 | $123.25 | |
BCBS
| Facility | $2,452.73 | $3,549.39 | $6,139.22 | |
Medica
| Facility | $116.00 | $191.40 | $220.40 | |
Medica
| Professional | $319.00 | $319.00 | $319.00 |