| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,504.80 | $1,504.80 | $1,504.80 | |
Aetna
| Professional | $0.82 | $0.85 | $0.88 | |
BCBS
| Facility | $96.00 | $376.92 | $628.08 | |
BCBS
| Professional | $80.40 | $96.00 | $111.60 | |
Medica
| Facility | $0.83 | $0.87 | $1.76 | |
Medica
| Professional | $141.37 | $141.37 | $141.37 |