| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $700.00 | $700.00 | $700.00 | |
Aetna
| Professional | $700.00 | $700.00 | $700.00 | |
Anthem BCBS
| Professional | $65.77 | $65.77 | $73.08 | |
Medica
| Facility | $700.00 | $735.00 | $1,463.00 |