| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $207.00 | $207.00 | $207.00 | |
Cigna
| Facility | $357.00 | $357.00 | $357.00 | |
Martin's Point
| Facility | $207.00 | $207.00 | $207.00 | |
Priority Health
| Facility | $357.00 | $357.00 | $357.00 |