| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,603.83 | $6,603.83 | $6,603.83 | |
Cigna
| Facility | $699.00 | $699.00 | $716.56 | |
Martin's Point
| Facility | $6,603.83 | $6,603.83 | $6,603.83 | |
United
| Facility | $11,831.32 | $11,831.32 | $11,831.32 |