| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,038.24 | $5,903.21 | $6,374.69 | |
Aetna
| Facility | 50 | $18,102.59 | $18,102.59 | $18,102.59 |
Cigna
| Facility | $1,005.81 | $1,005.81 | $1,005.81 | |
Martin's Point
| Facility | $2,038.24 | $5,903.21 | $15,669.32 | |
Martin's Point
| Facility | 50 | $18,102.59 | $18,102.59 | $18,102.59 |