| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.90 | $623.34 | $7,158.29 | |
Aetna
| Facility | 50 | $0.40 | $0.40 | $11,021.83 |
Martin's Point
| Facility | $0.90 | $0.90 | $7,158.29 | |
Martin's Point
| Facility | 50 | $0.40 | $0.40 | $11,021.83 |