| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,374.87 | $2,374.87 | $2,374.87 | |
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
BCBS
| Facility | $1.00 | $168.59 | $992.39 | |
BCBS
| Professional | $134.87 | $168.59 | $168.59 | |
Medica
| Facility | $2,080.00 | $2,374.87 | $4,013.53 |