| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $812.83 | $2,137.96 | $13,803.84 | |
Cigna
| Facility | $389.05 | $389.05 | $616.60 | |
Cigna
| Facility | 52 | $309.03 | $309.03 | $309.03 |
Martin's Point
| Facility | $812.83 | $870.96 | $13,803.84 |