| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $6,165.95 | $6,165.95 | $6,165.95 | |
Aetna
| Professional | $151.36 | $2,290.87 | $6,165.95 | |
Cigna
| Facility | $691.83 | $691.83 | $691.83 | |
Martin's Point
| Facility | $6,165.95 | $6,165.95 | $6,165.95 | |
Martin's Point
| Professional | $151.36 | $1,995.26 | $7,943.28 |