| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $18.41 | $18.41 | $18.41 | |
Aetna
| Professional | $4.05 | $18.41 | $18.41 | |
Capital Blue Cross
| Facility | $7.35 | $7.35 | $8.82 | |
Capital Blue Cross
| Professional | $5.88 | $5.88 | $5.88 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Martin's Point
| Professional | $18.41 | $18.41 | $18.41 | |
Priority Health
| Facility | $64.00 | $64.00 | $64.00 |