| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $616.60 | $616.60 | $616.60 | |
Aetna
| Professional | $575.44 | $616.60 | $660.69 | |
BCBS
| Facility | $1,819.70 | $2,818.38 | $4,570.88 | |
Medica
| Facility | $616.60 | $616.60 | $812.83 | |
United
| Facility | $302.00 | $1,047.13 | $1,778.28 |