| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,338.64 | $1,338.64 | $1,400.00 | |
CareSource
| Facility | $1,410.66 | $1,613.36 | $1,757.78 | |
Cigna
| Facility | $1,512.95 | $1,512.95 | $1,512.95 | |
Cigna
| Facility | AS | $147.82 | $147.82 | $147.82 |