| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $575.28 | $575.28 | $575.28 | |
Aetna
| Professional | $575.28 | $575.28 | $750.00 | |
Capital Blue Cross
| Facility | $5,000.00 | $8,639.91 | $79,506.39 | |
Capital Blue Cross
| Professional | $867.27 | $900.00 | $900.00 | |
Martin's Point
| Facility | $575.28 | $575.28 | $575.28 | |
Martin's Point
| Professional | $566.24 | $575.28 | $750.00 |