| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,258.10 | $1,258.10 | $1,400.00 | |
CareSource
| Facility | $1,289.58 | $1,470.38 | $1,602.00 | |
Cigna
| Facility | $1,377.35 | $1,377.35 | $1,377.35 | |
Cigna
| Facility | AS | $134.96 | $134.96 | $134.96 |