| 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 | $497.70 | |
BCBS
| Facility | $1,935.29 | $3,005.71 | $4,765.84 | |
Medica
| Facility | $229.63 | $229.63 | $321.48 | |
Medica
| Professional | $761.40 | $761.40 | $761.40 |