| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,116.74 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,342.36 | $1,342.36 | $1,462.52 | |
Cigna
| Facility | $1,280.74 | $1,280.74 | $1,280.74 | |
Cigna
| Facility | AS | $127.13 | $127.13 | $127.13 |