| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,074.61 | $1,074.61 | $1,400.00 | |
CareSource
| Facility | $1,070.25 | $1,232.53 | $1,342.86 | |
Cigna
| Facility | $1,151.16 | $1,151.16 | $1,151.16 | |
Cigna
| Facility | AS | $111.58 | $111.58 | $111.58 |