| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.91 | $65.91 | $65.91 | |
Aetna
| Professional | $65.91 | $65.91 | $65.91 | |
Anthem BCBS
| Professional | $49.83 | $59.47 | $81.73 | |
Martin's Point
| Professional | $65.91 | $65.91 | $65.91 |