| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $934.00 | $934.00 | $934.00 | |
Aetna
| Professional | $253.18 | $320.39 | $444.24 | |
BCBS
| Facility | $103.20 | $405.19 | $675.19 | |
BCBS
| Professional | $86.43 | $103.20 | $119.97 | |
Medica
| Facility | $268.37 | $444.24 | $635.26 | |
Medica
| Professional | $284.89 | $284.89 | $284.89 |