| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $5,188.14 | $5,188.14 | $6,283.69 | |
Aetna
| Facility | 50 | $2,358.81 | $2,358.81 | $2,358.81 |
Martin's Point
| Facility | $5,188.14 | $5,188.14 | $6,283.69 | |
Martin's Point
| Facility | 50 | $2,358.81 | $2,358.81 | $2,358.81 |