| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,398.83 | $4,677.35 | $6,165.95 | |
Aetna
| Professional | $2,089.30 | $2,398.83 | $2,511.89 | |
Anthem BCBS
| Professional | $123.03 | $123.03 | $128.82 | |
Medica
| Facility | $2,398.83 | $2,398.83 | $4,897.79 |