| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $232.40 | $3,839.00 | $8,247.00 | |
Aetna
| Professional | $161.31 | $232.40 | $287.80 | |
Martin's Point
| Facility | $657.00 | $4,761.00 | $8,247.00 | |
Martin's Point
| Professional | $156.72 | $243.63 | $700.00 | |
United
| Facility | $625.00 | $2,391.00 | $6,322.00 | |
United
| Professional | $238.79 | $329.07 | $561.13 |