| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $148.27 | $148.27 | $148.27 | |
Aetna
| Professional | $93.21 | $113.77 | $148.27 | |
BCBS
| Facility | $655.35 | $751.73 | $782.00 | |
BCBS
| Professional | $200.44 | $200.44 | $200.44 | |
Medica
| Facility | $90.62 | $113.77 | $216.54 | |
Medica
| Professional | $728.46 | $728.46 | $728.46 |