| 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 | $229.63 | |
Anthem BCBS
| Professional | $485.17 | $500.00 | $500.00 | |
Medica
| Facility | $229.63 | $252.59 | $555.70 | |
Medica
| Professional | $761.40 | $761.40 | $761.40 |