| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.72 | $758.58 | $5,495.41 | |
Aetna
| Facility | 54 | $741.31 | $776.25 | $1,023.29 |
Martin's Point
| Facility | $0.72 | $758.58 | $5,495.41 | |
Martin's Point
| Facility | 54 | $741.31 | $776.25 | $1,023.29 |