| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $350.00 | $350.00 | $350.00 | |
Aetna
| Professional | $350.00 | $350.00 | $350.00 | |
Emblem Health
| Professional | $570.32 | $570.32 | $570.32 | |
Horizon BCBS
| Professional | $450.00 | $450.00 | $450.00 |