| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,010.24 | $11,886.61 | $11,886.61 | |
CareSource
| Facility | $1,396.51 | $1,556.78 | $1,696.14 | |
Cigna
| Facility | $1,498.78 | $1,498.78 | $1,498.78 | |
Cigna
| Facility | AS | $149.31 | $149.31 | $149.31 |