| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,229.17 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,308.25 | $1,469.62 | $1,601.17 | |
Cigna
| Facility | $1,399.57 | $1,399.57 | $1,399.57 | |
Cigna
| Facility | AS | $138.28 | $138.28 | $138.28 |