| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.60 | $45.60 | $45.60 | |
Aetna
| Professional | $45.60 | $45.60 | $57.00 | |
BCBS
| Facility | $1,602.67 | $1,602.67 | $9,433.95 | |
BCBS
| Professional | $1,282.14 | $1,602.67 | $1,602.67 | |
Medica
| Facility | $45.60 | $45.60 | $77.06 |