| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,103.42 | $6,603.11 | $15,168.21 | |
Aetna
| Facility | 50 | $4,528.96 | $7,368.84 | $9,634.23 |
Martin's Point
| Facility | $4,326.96 | $8,521.52 | $15,971.93 | |
Martin's Point
| Facility | 50 | $4,005.73 | $6,714.86 | $11,141.20 |