| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,374.87 | $2,374.87 | $6,158.76 | |
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
Anthem BCBS
| Professional | $124.22 | $124.22 | $125.94 | |
Medica
| Facility | $100.00 | $2,374.87 | $4,631.00 |