| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.93 | $6,918.31 | $23,988.33 | |
Aetna
| Facility | 50 | $3,981.07 | $8,511.38 | $79,432.82 |
Martin's Point
| Facility | $0.93 | $4,786.30 | $23,988.33 | |
Martin's Point
| Facility | 50 | $3,981.07 | $8,511.38 | $85,113.80 |