| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,056.00 | $2,747.00 | $8,017.00 | |
Aetna
| Professional | $65.00 | $65.00 | $65.00 | |
Martin's Point
| Facility | $954.00 | $3,120.00 | $8,017.00 | |
Martin's Point
| Professional | $934.00 | $1,659.00 | $7,197.00 | |
United
| Facility | $2,228.00 | $4,563.00 | $8,261.00 |