| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,230.67 | $1,230.67 | $1,400.00 | |
CareSource
| Facility | $1,230.98 | $1,417.92 | $1,544.85 | |
Cigna
| Facility | $1,325.21 | $1,325.21 | $1,325.21 | |
Cigna
| Facility | AS | $128.44 | $128.44 | $128.44 |