| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $358.00 | $358.00 | $358.00 | |
Aetna
| Professional | $358.00 | $358.00 | $358.00 | |
BCBS
| Facility | $138.47 | $327.16 | $809.07 | |
BCBS
| Professional | $140.63 | $173.10 | $408.94 | |
Medica
| Facility | $358.00 | $393.80 | $757.51 |