| 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
| Professional | $48.98 | $64.57 | $70.79 | |
Medica
| Facility | $120.23 | $707.95 | $1,202.26 | |
United
| Facility | $104.71 | $104.71 | $104.71 |