| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $864.70 | $1,782.82 | $4,078.48 | |
Aetna
| Facility | 50 | $3,935.48 | $3,935.48 | $4,249.80 |
Cigna
| Facility | $1,005.81 | $1,005.81 | $1,005.81 | |
Martin's Point
| Facility | $0.86 | $2,951.60 | $6,375.05 | |
Martin's Point
| Facility | 50 | $3,935.48 | $3,935.48 | $4,249.80 |