| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,213.42 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,302.10 | $1,458.70 | $1,589.27 | |
Cigna
| Facility | $1,390.85 | $1,390.85 | $1,390.85 | |
Cigna
| Facility | AS | $137.94 | $137.94 | $137.94 |