| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $59.25 | $66.47 | $66.47 | |
Aetna
| Professional | $48.23 | $61.50 | $68.59 | |
Capital Blue Cross
| Facility | $5,000.00 | $8,639.91 | $79,506.39 | |
Capital Blue Cross
| Professional | $41.47 | $43.03 | $43.03 | |
Martin's Point
| Facility | $66.47 | $66.47 | $66.47 | |
Martin's Point
| Professional | $48.23 | $61.50 | $68.59 |