| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,097.19 | $1,400.00 | $1,723.54 | |
CareSource
| Facility | $1,112.30 | $1,199.56 | $1,454.23 | |
Cigna
| Facility | $1,281.49 | $1,281.49 | $1,281.49 | |
Cigna
| Facility | AS | $127.09 | $127.09 | $127.09 |