| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,374.87 | $2,374.87 | $2,781.46 | |
Aetna
| Professional | $2,374.87 | $2,374.87 | $2,374.87 | |
Martin's Point
| Facility | $2,374.87 | $2,781.46 | $3,450.15 | |
Martin's Point
| Professional | $2,374.87 | $2,374.87 | $2,374.87 |