| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $540.96 | $540.96 | $540.96 | |
Aetna
| Professional | $356.04 | $540.96 | $876.05 | |
BCBS
| Facility | $393.84 | $493.21 | $1,150.33 | |
BCBS
| Professional | $172.66 | $215.83 | $215.83 | |
Medica
| Facility | $542.08 | $574.60 | $1,194.30 | |
Medica
| Professional | $1,274.40 | $1,274.40 | $1,274.40 |