| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,737.80 | $3,548.13 | $10,471.29 | |
Aetna
| Facility | 50 | $9,772.37 | $9,772.37 | $9,772.37 |
Martin's Point
| Facility | $1,737.80 | $3,548.13 | $10,471.29 | |
Martin's Point
| Facility | 50 | $9,772.37 | $9,772.37 | $9,772.37 |