| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $917.21 | $955.42 | $5,863.26 | |
Aetna
| Facility | 50 | $96.53 | $722.22 | $5,778.35 |
Martin's Point
| Facility | $0.40 | $2,358.81 | $14,197.80 | |
Martin's Point
| Facility | 50 | $96.53 | $722.22 | $6,449.26 |