| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13,531.66 | $13,531.66 | $13,531.66 | |
Aetna
| Professional | $13,531.66 | $13,531.66 | $13,531.66 | |
BCBS
| Professional | $1,709.75 | $2,000.80 | $2,035.38 | |
Medica
| Facility | $80.00 | $13,531.66 | $16,247.00 |