| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,671.00 | $3,617.00 | $6,329.00 | |
Aetna
| Professional | $612.00 | $2,260.00 | $4,474.00 | |
BCBS
| Facility | $36.29 | $135.75 | $223.44 | |
BCBS
| Professional | $23.55 | $31.40 | $39.25 | |
Medica
| Facility | $100.00 | $100.00 | $100.00 |