| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $405.28 | $454.40 | $454.40 | |
Aetna
| Professional | $381.64 | $405.28 | $717.13 | |
Capital Blue Cross
| Facility | $5,000.00 | $8,639.91 | $79,506.39 | |
Capital Blue Cross
| Professional | $869.04 | $901.84 | $901.84 | |
Martin's Point
| Facility | $454.40 | $454.40 | $454.40 | |
Martin's Point
| Professional | $329.59 | $405.28 | $717.13 |