| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.65 | $700.00 | $700.00 | |
BCBS
| Facility | $630.55 | $2,475.73 | $4,125.43 | |
BCBS
| Professional | $528.09 | $630.55 | $733.03 | |
Medica
| Facility | $700.00 | $700.00 | $1,029.00 |