| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $800.00 | $2,505.00 | $8,017.00 | |
Aetna
| Professional | $188.00 | $1,023.00 | $5,958.00 | |
Martin's Point
| Facility | $657.00 | $2,422.00 | $8,017.00 | |
Martin's Point
| Professional | $641.00 | $1,541.00 | $7,197.00 | |
United
| Facility | $144.00 | $674.00 | $4,300.00 |