| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $285.93 | $285.93 | $285.93 | |
Aetna
| Professional | $218.27 | $219.47 | $285.93 | |
BCBS
| Professional | $302.39 | $302.39 | $302.39 | |
Medica
| Facility | $128.90 | $219.47 | $294.08 | |
Medica
| Professional | $1,328.36 | $1,328.36 | $1,328.36 |