| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $309.03 | $309.03 | $309.03 | |
Aetna
| Professional | $309.03 | $309.03 | $575.44 | |
BCBS
| Facility | $1,819.70 | $2,818.38 | $4,570.88 | |
Medica
| Facility | $457.09 | $457.09 | $616.60 | |
United
| Facility | $131.83 | $457.09 | $776.25 |