| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,586.04 | $5,348.46 | $8,710.79 | |
Aetna
| Facility | AS | $2,117.96 | $2,117.96 | $2,117.96 |
Martin's Point
| Facility | $4,952.33 | $8,194.73 | $18,790.22 | |
Martin's Point
| Facility | AS | $2,117.96 | $2,117.96 | $2,117.96 |