| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,057.11 | $1,057.11 | $1,400.00 | |
CareSource
| Facility | $1,056.10 | $1,213.60 | $1,322.24 | |
Cigna
| Facility | $1,137.72 | $1,137.72 | $1,137.72 | |
Cigna
| Facility | AS | $110.65 | $110.65 | $110.65 |