| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $832.00 | $2,505.00 | $7,799.00 | |
Aetna
| Professional | $473.00 | $1,686.00 | $4,573.00 | |
Martin's Point
| Facility | $800.00 | $2,422.00 | $7,799.00 | |
Martin's Point
| Professional | $317.00 | $818.00 | $5,457.00 |