| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17,293.82 | $17,293.82 | $17,293.82 | |
Cigna
| Facility | $817.93 | $817.93 | $1,835.00 | |
Cigna
| Facility | AS | $80.59 | $80.59 | $80.59 |
Martin's Point
| Facility | $5,288.72 | $5,288.72 | $17,293.82 |