| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.56 | $124.56 | $124.56 | |
Aetna
| Professional | $118.13 | $124.56 | $130.08 | |
Cigna
| Professional | $13.17 | $13.17 | $13.17 | |
Martin's Point
| Professional | $118.13 | $124.56 | $143.24 |