| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.57 | $48.53 | $48.53 | |
Aetna
| Professional | $31.03 | $43.15 | $49.71 | |
Capital Blue Cross
| Facility | $5,000.00 | $8,639.91 | $79,506.39 | |
Capital Blue Cross
| Professional | $42.48 | $44.09 | $44.09 | |
Martin's Point
| Facility | $48.53 | $48.53 | $48.53 | |
Martin's Point
| Professional | $31.03 | $43.15 | $49.71 |