| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,119.00 | $3,623.00 | $8,017.00 | |
Aetna
| Professional | $1,068.00 | $1,820.00 | $7,197.00 | |
Martin's Point
| Facility | $1,013.00 | $3,839.00 | $8,017.00 | |
Martin's Point
| Professional | $1,119.00 | $2,843.00 | $7,197.00 | |
United
| Facility | $2,155.00 | $3,475.00 | $6,368.00 |