| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $691.83 | $3,890.45 | $6,760.83 | |
Cigna
| Facility | $436.52 | $436.52 | $616.60 | |
Cigna
| Facility | 22 | $524.81 | $524.81 | $524.81 |
Martin's Point
| Facility | $457.09 | $3,890.45 | $6,918.31 |