| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $585.04 | $585.04 | $585.04 | |
Aetna
| Professional | $585.04 | $585.04 | $585.04 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $318.73 | |
Medica
| Facility | $585.04 | $643.54 | $1,415.80 | |
Medica
| Professional | $1,385.62 | $1,385.62 | $1,385.62 |