| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,908.26 | $1,908.26 | $1,908.26 | |
Aetna
| Professional | $1,908.26 | $1,908.26 | $1,908.26 | |
BCBS
| Professional | $838.36 | $991.23 | $1,003.95 | |
Medica
| Facility | $80.00 | $1,908.26 | $5,724.78 |