| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12,103.44 | $12,103.44 | $12,103.44 | |
CareSource
| Facility | $1,362.77 | $1,557.01 | $1,696.40 | |
Cigna
| Facility | $1,461.02 | $1,461.02 | $1,461.02 | |
Cigna
| Facility | AS | $143.09 | $143.09 | $143.09 |