| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1.00 | $1.00 | $1.00 | |
Capital Blue Cross
| Facility | $5,011.87 | $8,511.38 | $77,624.71 | |
Capital Blue Cross
| Professional | $1.51 | $1.58 | $1.58 | |
Cigna
| Professional | $0.87 | $0.87 | $0.87 | |
Martin's Point
| Professional | $1.00 | $1.00 | $1.00 |