| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,086.30 | $1,086.30 | $1,400.00 | |
CareSource
| Facility | $1,098.47 | $1,255.18 | $1,367.54 | |
Cigna
| Facility | $1,176.14 | $1,176.14 | $1,176.14 | |
Cigna
| Facility | AS | $114.83 | $114.83 | $114.83 |