| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $854.03 | $854.03 | $854.03 | |
Cigna
| Facility | $57.14 | $123.20 | $147.96 | |
Martin's Point
| Professional | $854.03 | $854.03 | $854.03 | |
Priority Health
| Facility | $57.14 | $114.74 | $123.20 |