| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.42 | $234.42 | $234.42 | |
Aetna
| Professional | $117.49 | $234.42 | $446.68 | |
BCBS
| Facility | $50.12 | $50.12 | $69.18 | |
BCBS
| Professional | $40.74 | $50.12 | $50.12 | |
Medica
| Facility | $154.88 | $239.88 | $489.78 |