| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,500.00 | $3,500.00 | $3,500.00 | |
Cigna
| Facility | $244.91 | $244.91 | $699.00 | |
Cigna
| Facility | 52 | $191.49 | $191.49 | $191.49 |
Martin's Point
| Facility | $3,500.00 | $3,500.00 | $3,500.00 |