| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.43 | $79.43 | $79.43 | |
Aetna
| Professional | $79.43 | $79.43 | $89.13 | |
BCBS
| Facility | $1,819.70 | $2,818.38 | $4,570.88 | |
Medica
| Facility | $79.43 | $79.43 | $112.20 | |
United
| Facility | $56.23 | $194.98 | $338.84 |