| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $64.92 | |
Aetna
| Professional | $51.12 | $51.12 | $604.41 | |
Emblem Health
| Professional | $38,249.62 | $38,249.62 | $38,249.62 | |
Martin's Point
| Facility | $51.12 | $51.12 | $64.92 | |
Martin's Point
| Professional | $51.12 | $51.12 | $604.41 |