| 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 | $320.39 | |
Anthem BCBS
| Professional | $188.11 | $650.00 | $650.00 | |
Medica
| Facility | $320.39 | $348.31 | $712.68 | |
Medica
| Professional | $284.89 | $284.89 | $284.89 |