| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $831.76 | $2,691.53 | $8,317.64 | |
Aetna
| Professional | $186.21 | $263.03 | $316.23 | |
Martin's Point
| Facility | $660.69 | $2,344.23 | $8,317.64 | |
Martin's Point
| Professional | $186.21 | $263.03 | $1,230.27 | |
United
| Facility | $223.87 | $1,071.52 | $3,890.45 | |
United
| Professional | $263.03 | $331.13 | $549.54 |