| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $239.37 | $239.37 | $304.00 | |
Aetna
| Professional | $239.37 | $239.37 | $1,125.84 | |
Capital Blue Cross
| Facility | $967.00 | $967.00 | $967.00 | |
Martin's Point
| Facility | $239.37 | $239.37 | $304.00 | |
Martin's Point
| Professional | $239.37 | $239.37 | $519.00 |