| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.28 | $89.28 | $89.28 | |
Aetna
| Professional | $84.27 | $88.00 | $89.28 | |
Emblem Health
| Professional | $38,249.62 | $38,249.62 | $38,249.62 | |
Horizon BCBS
| Facility | $185.63 | $217.66 | $457.60 |