| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $987.52 | $987.52 | $987.52 | |
Aetna
| Professional | $640.00 | $987.52 | $1,820.00 | |
BCBS
| Facility | $138.47 | $327.16 | $809.07 | |
BCBS
| Professional | $140.63 | $173.10 | $408.94 | |
Medica
| Facility | $672.00 | $1,086.27 | $2,074.80 |