| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $123.03 | $123.03 | |
Aetna
| Professional | $87.10 | $87.10 | $1,318.26 | |
BCBS
| Facility | $275.42 | $295.12 | $630.96 | |
BCBS
| Professional | $89.13 | $112.20 | $112.20 | |
Medica
| Facility | $89.13 | $707.95 | $977.24 | |
United
| Facility | $724.44 | $741.31 | $1,000.00 |