| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.91 | $22.91 | $22.91 | |
Aetna
| Professional | $5.01 | $22.91 | $70.79 | |
Cigna
| Facility | $100.00 | $100.00 | $151.36 | |
Cigna
| Professional | $50.12 | $50.12 | $50.12 | |
Martin's Point
| Facility | $22.91 | $22.91 | $22.91 | |
Martin's Point
| Professional | $5.01 | $22.91 | $83.18 |