| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,586.04 | $4,586.04 | $4,982.79 | |
Cigna
| Facility | $473.24 | $473.24 | $699.00 | |
Cigna
| Facility | AS | $47.01 | $47.01 | $47.01 |
Martin's Point
| Facility | $4,586.04 | $4,982.79 | $15,907.70 |