| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,807.19 | $1,807.19 | $11,645.25 | |
Cigna
| Facility | $699.00 | $699.00 | $929.72 | |
Cigna
| Facility | AS | $92.27 | $92.27 | $92.27 |
Martin's Point
| Facility | $1,807.19 | $11,645.25 | $25,583.41 |