| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,462.00 | $4,989.00 | $9,788.00 | |
Aetna
| Professional | $1,426.00 | $2,843.00 | $7,799.00 | |
Martin's Point
| Facility | $1,301.00 | $5,342.00 | $10,527.00 | |
Martin's Point
| Professional | $1,544.00 | $2,843.00 | $7,799.00 | |
United
| Facility | $448.00 | $2,391.00 | $6,322.00 |