| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15,488.17 | $15,488.17 | $15,488.17 | |
Aetna
| Professional | $309.03 | $1,288.25 | $1,862.09 | |
Martin's Point
| Facility | $15,488.17 | $15,488.17 | $15,488.17 | |
Martin's Point
| Professional | $309.03 | $1,288.25 | $1,862.09 |