| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,650.96 | $1,650.96 | $1,650.96 | |
Cigna
| Facility | $222.19 | $222.19 | $699.00 | |
Martin's Point
| Facility | $1,650.96 | $1,650.96 | $1,650.96 | |
United
| Facility | $3,793.98 | $3,793.98 | $3,793.98 |