| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $225.15 | $225.15 | $225.15 | |
Aetna
| Professional | $225.15 | $225.15 | $227.79 | |
BCBS
| Professional | $413.00 | $413.00 | $413.00 | |
Medica
| Facility | $225.15 | $239.18 | $400.08 | |
Medica
| Professional | $243.84 | $430.01 | $1,733.46 |