| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,467.37 | $3,467.37 | $3,467.37 | |
Cigna
| Facility | $363.08 | $363.08 | $691.83 | |
Cigna
| Facility | 22 | $436.52 | $436.52 | $436.52 |
Cigna
| Facility | 52 | $295.12 | $295.12 | $295.12 |
Martin's Point
| Facility | $3,467.37 | $3,467.37 | $3,467.37 |