| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.21 | $19.21 | $24.68 | |
Aetna
| Professional | $19.21 | $19.21 | $220.00 | |
Emblem Health
| Professional | $38,249.62 | $38,249.62 | $38,249.62 | |
Horizon BCBS
| Professional | $38.25 | $45.00 | $45.00 |