| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $655.61 | $3,839.00 | $8,247.00 | |
Aetna
| Professional | $655.61 | $655.61 | $690.12 | |
Martin's Point
| Facility | $657.00 | $4,761.00 | $8,247.00 | |
Martin's Point
| Professional | $655.61 | $655.61 | $1,544.00 | |
United
| Facility | $637.00 | $2,391.00 | $6,000.00 |