| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,650.96 | $3,187.35 | $5,207.88 | |
Aetna
| Facility | 50 | $3,463.15 | $5,903.20 | $8,609.21 |
Cigna
| Facility | $814.23 | $814.23 | $814.23 | |
Martin's Point
| Facility | $1,705.77 | $3,301.55 | $10,795.29 | |
Martin's Point
| Facility | 50 | $3,463.15 | $6,375.05 | $9,450.12 |