| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $640.00 | $640.00 | $640.00 | |
Aetna
| Professional | $640.00 | $640.00 | $640.00 | |
Anthem BCBS
| Professional | $6.26 | $392.70 | $424.92 | |
Medica
| Facility | $640.00 | $782.72 | $1,599.48 |