| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $5.23 | $22.16 | $22.16 | |
Cigna
| Professional | $113.63 | $228.00 | $228.00 | |
Martin's Point
| Professional | $22.16 | $22.16 | $22.16 | |
Priority Health
| Professional | $113.63 | $142.03 | $228.00 |