| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $549.15 | $549.15 | $549.15 | |
Aetna
| Professional | $351.99 | $549.15 | $632.99 | |
BCBS
| Professional | $1,028.26 | $1,035.97 | $1,218.79 | |
Medica
| Facility | $509.88 | $549.15 | $1,647.45 |