| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,436.57 | $1,436.57 | |
CareSource
| Facility | $1,432.31 | $1,650.80 | $1,798.58 | |
Cigna
| Facility | $1,536.61 | $1,536.61 | $1,536.61 | |
Cigna
| Facility | AS | $148.79 | $148.79 | $148.79 |