| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $222.41 | $222.41 | $222.41 | |
Aetna
| Professional | $222.41 | $222.41 | $225.02 | |
BCBS
| Professional | $272.00 | $272.00 | $272.00 | |
Medica
| Facility | $222.41 | $236.27 | $400.08 | |
Medica
| Professional | $234.64 | $430.01 | $1,712.50 |