| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $320.39 | $320.39 | $320.39 | |
Aetna
| Professional | $253.18 | $320.39 | $444.24 | |
BCBS
| Facility | $159.05 | $172.20 | $748.04 | |
BCBS
| Professional | $112.28 | $140.35 | $140.35 | |
Medica
| Facility | $253.18 | $320.39 | $541.48 | |
Medica
| Professional | $284.89 | $284.89 | $284.89 |