| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,301.55 | $3,301.55 | $3,301.55 | |
Cigna
| Facility | $657.10 | $657.10 | $1,835.00 | |
Cigna
| Facility | AS | $65.17 | $65.17 | $65.17 |
Martin's Point
| Facility | $3,301.55 | $3,301.55 | $3,301.55 |