| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $59.28 | $59.28 | $78.00 | |
Cigna
| Facility | $526.69 | $526.69 | $526.69 | |
Cigna
| Professional | $447.69 | $526.69 | $542.49 | |
Martin's Point
| Professional | $59.28 | $59.28 | $78.00 | |
Priority Health
| Facility | $526.69 | $526.69 | $526.69 | |
Priority Health
| Professional | $447.69 | $526.69 | $630.50 |