| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.86 | $13.86 | $13.86 | |
Aetna
| Professional | $6.04 | $27.73 | $48.41 | |
Emblem Health
| Professional | $38,249.62 | $38,249.62 | $38,249.62 | |
Horizon BCBS
| Facility | $60.42 | $69.73 | $148.94 | |
Horizon BCBS
| Professional | $48.88 | $57.50 | $57.50 |