| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $973.77 | $973.77 | $973.77 | |
Aetna
| Professional | $973.77 | $973.77 | $973.77 | |
BCBS
| Professional | $1,651.41 | $1,945.74 | $2,129.67 | |
Medica
| Facility | $973.77 | $973.77 | $1,801.47 |