| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.43 | $412.43 | $412.43 | |
Aetna
| Professional | $224.21 | $412.43 | $412.43 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $159.25 | |
Medica
| Facility | $412.43 | $448.35 | $917.38 | |
Medica
| Professional | $168.32 | $168.32 | $168.32 |