| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,210.56 | $1,210.56 | $1,400.00 | |
CareSource
| Facility | $1,277.17 | $1,459.74 | $1,590.41 | |
Cigna
| Facility | $1,370.32 | $1,370.32 | $1,370.32 | |
Cigna
| Facility | AS | $133.99 | $133.99 | $133.99 |