| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $233.56 | $233.56 | $296.62 | |
Aetna
| Professional | $233.56 | $233.56 | $2,006.33 | |
Capital Blue Cross
| Facility | $967.00 | $967.00 | $967.00 | |
Martin's Point
| Facility | $233.56 | $233.56 | $296.62 | |
Martin's Point
| Professional | $233.56 | $233.56 | $2,006.33 |