| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,452.03 | $12,533.96 | $18,403.41 | |
CareSource
| Facility | $1,418.60 | $1,588.58 | $1,730.78 | |
Cigna
| Facility | $1,515.50 | $1,515.50 | $1,515.50 | |
Cigna
| Facility | AS | $150.40 | $150.40 | $150.40 |