| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,426.00 | $4,993.00 | $8,933.00 | |
Aetna
| Professional | $11,103.76 | $11,103.76 | $11,103.76 | |
Martin's Point
| Facility | $1,151.00 | $5,350.00 | $9,617.00 | |
Martin's Point
| Professional | $685.00 | $2,660.00 | $11,103.76 | |
United
| Facility | $1,747.00 | $2,824.00 | $5,678.00 |