| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $594.40 | $594.40 | $594.40 | |
Aetna
| Professional | $594.40 | $1,052.08 | $1,052.08 | |
BCBS
| Professional | $450.46 | $530.75 | $580.91 | |
Medica
| Facility | $594.40 | $772.72 | $1,783.20 |