| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $7,413.10 | $15,135.61 | |
Cigna
| Facility | $436.52 | $436.52 | $870.96 | |
Cigna
| Facility | 52 | $346.74 | $346.74 | $346.74 |
Martin's Point
| Facility | $389.05 | $5,754.40 | $15,135.61 |