| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.13 | $68.13 | $682.00 | |
Aetna
| Professional | $68.13 | $68.13 | $88.72 | |
Cigna
| Professional | $35.29 | $35.29 | $35.29 | |
Martin's Point
| Facility | $68.13 | $682.00 | $4,060.00 | |
Martin's Point
| Professional | $68.13 | $68.13 | $88.72 | |
Priority Health
| Professional | $35.29 | $35.29 | $35.29 |