| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.40 | $104.40 | $104.40 | |
Cigna
| Professional | $130.00 | $130.00 | $140.40 | |
Martin's Point
| Professional | $104.40 | $104.40 | $104.40 | |
Priority Health
| Professional | $130.00 | $130.00 | $140.40 |