| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,945.79 | $2,358.81 | $5,188.14 | |
Aetna
| Facility | 50 | $2,305.84 | $2,305.84 | $9,223.36 |
Martin's Point
| Facility | $1,945.79 | $2,358.81 | $5,511.33 | |
Martin's Point
| Facility | 50 | $0.94 | $2,305.84 | $9,223.36 |