| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,171.36 | $1,171.36 | $1,400.00 | |
CareSource
| Facility | $1,200.29 | $1,364.14 | $1,486.24 | |
Cigna
| Facility | $1,283.40 | $1,283.40 | $1,283.40 | |
Cigna
| Facility | AS | $125.68 | $125.68 | $125.68 |