| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.40 | $2,691.53 | $11,748.98 | |
Aetna
| Professional | $389.05 | $630.96 | $977.24 | |
Martin's Point
| Facility | $0.40 | $0.40 | $11,748.98 | |
Martin's Point
| Professional | $389.05 | $537.03 | $977.24 |