| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,820.00 | $1,820.00 | $1,820.00 | |
Aetna
| Professional | $640.00 | $1,820.00 | $1,820.00 | |
Emblem Health
| Professional | $25.00 | $462.60 | $675.90 | |
Horizon BCBS
| Professional | $510.00 | $600.00 | $600.00 |