| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $296.00 | $296.00 | $296.00 | |
Aetna
| Professional | $212.34 | $212.34 | $212.34 | |
BCBS
| Facility | $65.23 | $309.99 | $309.99 | |
BCBS
| Professional | $421.68 | $421.68 | $421.68 | |
Medica
| Facility | $212.34 | $325.88 | $447.13 |