| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,040.07 | $1,400.00 | $1,700.00 | |
CareSource
| Facility | $1,121.88 | $1,254.40 | $1,366.69 | |
Cigna
| Facility | $1,197.79 | $1,197.79 | $1,197.79 | |
Cigna
| Facility | AS | $118.97 | $118.97 | $118.97 |