| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $594.00 | $2,747.00 | $8,017.00 | |
Aetna
| Professional | $27.58 | $27.58 | $35.18 | |
Martin's Point
| Facility | $918.00 | $3,120.00 | $8,017.00 | |
Martin's Point
| Professional | $27.58 | $27.58 | $2,605.00 | |
United
| Facility | $144.00 | $674.00 | $4,300.00 |