| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.95 | $707.95 | $707.95 | |
Aetna
| Professional | $707.95 | $707.95 | $707.95 | |
BCBS
| Facility | $54.95 | $56.23 | $56.23 | |
BCBS
| Professional | $416.87 | $416.87 | $416.87 | |
Medica
| Facility | $588.84 | $707.95 | $1,174.90 | |
United
| Facility | $138.04 | $141.25 | $190.55 |