| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,110.05 | $1,400.00 | $3,050.00 | |
CareSource
| Facility | $1,178.93 | $1,348.20 | $1,468.88 | |
Cigna
| Facility | $1,262.82 | $1,262.82 | $1,262.82 | |
Cigna
| Facility | AS | $125.34 | $125.34 | $125.34 |