| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $102.51 | $102.51 | $102.51 | |
Aetna
| Professional | $78.12 | $102.09 | $112.32 | |
Cigna
| Professional | $2.00 | $2.00 | $2.00 | |
Martin's Point
| Professional | $78.12 | $102.51 | $112.32 |