| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $221.36 | $2,016.46 | $3,614.38 | |
Aetna
| Facility | 50 | $1,795.27 | $4,611.68 | $5,188.14 |
Martin's Point
| Facility | $0.94 | $2,016.46 | $3,614.38 | |
Martin's Point
| Facility | 50 | $0.40 | $2,045.00 | $5,188.14 |