| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $756.23 | $10,325.79 | $22,247.59 | |
Cigna
| Facility | $723.23 | $723.23 | $1,363.00 | |
Cigna
| Facility | AS | $71.36 | $71.36 | $71.36 |
Martin's Point
| Facility | $6,599.84 | $13,464.65 | $22,247.59 |