| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,394.15 | $1,394.15 | $1,400.00 | |
CareSource
| Facility | $1,387.27 | $1,599.52 | $1,742.69 | |
Cigna
| Facility | $1,491.29 | $1,491.29 | $1,491.29 | |
Cigna
| Facility | AS | $144.38 | $144.38 | $144.38 |