| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.87 | $753.00 | $4,803.25 | |
Aetna
| Professional | $47.64 | $55.95 | $61.39 | |
AmeriHealth
| Facility | $99.00 | $99.00 | $99.00 | |
Emblem Health
| Professional | $55.55 | $74.98 | $97.21 |