| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,003.38 | $1,400.00 | $2,300.00 | |
CareSource
| Facility | $1,080.92 | $1,207.72 | $1,315.83 | |
Cigna
| Facility | $1,155.76 | $1,155.76 | $1,155.76 | |
Cigna
| Facility | AS | $114.90 | $114.90 | $114.90 |