| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,051.26 | $11,418.65 | $11,418.65 | |
CareSource
| Facility | $1,390.10 | $1,588.56 | $1,730.75 | |
Cigna
| Facility | $1,487.30 | $1,487.30 | $1,487.30 | |
Cigna
| Facility | AS | $147.38 | $147.38 | $147.38 |