| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.25 | $123.25 | $123.25 | |
Aetna
| Professional | $118.90 | $123.25 | $123.25 | |
Anthem BCBS
| Professional | $45.00 | $45.00 | $123.25 | |
Martin's Point
| Professional | $123.25 | $123.25 | $123.25 |