| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $311.06 | $348.77 | $348.77 | |
Aetna
| Professional | $252.98 | $332.41 | $422.84 | |
Capital Blue Cross
| Facility | $5,000.00 | $8,639.91 | $79,506.39 | |
Capital Blue Cross
| Professional | $409.19 | $424.63 | $424.63 | |
Martin's Point
| Facility | $348.77 | $348.77 | $348.77 | |
Martin's Point
| Professional | $252.98 | $332.41 | $422.84 |