| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $540.96 | $540.96 | $540.96 | |
Aetna
| Professional | $540.96 | $540.96 | $677.60 | |
Anthem BCBS
| Professional | $241.64 | $650.00 | $650.00 | |
Medica
| Facility | $542.08 | $634.23 | $1,266.47 | |
Medica
| Professional | $1,274.40 | $1,274.40 | $1,274.40 |