| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $248.71 | $248.71 | $248.71 | |
Aetna
| Professional | $248.71 | $248.71 | $248.71 | |
Anthem BCBS
| Professional | $60.00 | $60.00 | $60.00 | |
Medica
| Facility | $248.71 | $276.07 | $601.88 | |
Medica
| Professional | $449.39 | $449.39 | $449.39 |