| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $641.04 | $641.04 | $641.04 | |
Aetna
| Professional | $412.23 | $641.04 | $641.04 | |
BCBS
| Professional | $1,850.92 | $1,864.80 | $2,193.88 | |
Medica
| Facility | $596.64 | $641.04 | $1,923.12 |