| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $229.63 | $229.63 | $229.63 | |
Aetna
| Professional | $229.63 | $229.63 | $1,096.79 | |
BCBS
| Facility | $227.25 | $251.07 | $748.04 | |
BCBS
| Professional | $112.28 | $140.35 | $140.35 | |
Medica
| Facility | $229.63 | $229.63 | $751.81 | |
Medica
| Professional | $761.40 | $761.40 | $761.40 |