| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $187.87 | $187.87 | $14,650.28 | |
Cigna
| Facility | $179.16 | $179.16 | $699.00 | |
Cigna
| Facility | AS | $17.41 | $17.41 | $17.41 |
Martin's Point
| Facility | $14,650.28 | $14,650.28 | $14,650.28 |