| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $4,687.85 | $4,687.85 | $7,180.88 | |
Cigna
| Facility | $982.00 | $982.00 | $1,047.98 | |
Cigna
| Facility | AS | $102.97 | $102.97 | $102.97 |
Martin's Point
| Facility | $4,910.45 | $4,910.45 | $4,910.45 |