| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,650.96 | $1,650.96 | $6,239.89 | |
Aetna
| Facility | 50 | $1,174.30 | $8,254.79 | $21,028.15 |
Martin's Point
| Facility | $1,650.96 | $6,239.89 | $41,059.35 | |
Martin's Point
| Facility | 50 | $0.94 | $9,170.25 | $30,244.41 |