| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,462.00 | $5,350.00 | $10,527.00 | |
Aetna
| Professional | $700.00 | $2,409.00 | $8,389.00 | |
Martin's Point
| Facility | $1,426.00 | $5,526.00 | $11,083.00 | |
Martin's Point
| Professional | $700.00 | $2,843.00 | $8,389.00 | |
United
| Facility | $625.00 | $2,391.00 | $6,322.00 |