| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $379.19 | $379.19 | $379.19 | |
Aetna
| Professional | $289.45 | $291.08 | $379.19 | |
BCBS
| Professional | $844.04 | $844.04 | $844.04 | |
Medica
| Facility | $164.34 | $291.08 | $390.05 | |
Medica
| Professional | $1,750.16 | $1,750.16 | $1,750.16 |