| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.82 | $169.82 | $169.82 | |
Aetna
| Professional | $169.82 | $169.82 | $389.05 | |
BCBS
| Facility | $1,819.70 | $2,818.38 | $4,466.84 | |
Medica
| Facility | $169.82 | $169.82 | $302.00 | |
United
| Facility | $158.49 | $537.03 | $933.25 |