| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,801.55 | $9,188.50 | $9,188.50 | |
CareSource
| Facility | $1,252.40 | $1,395.17 | $1,520.06 | |
Cigna
| Facility | $1,341.75 | $1,341.75 | $1,341.75 | |
Cigna
| Facility | AS | $133.40 | $133.40 | $133.40 |