| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,379.14 | $1,379.14 | $2,106.98 | |
CareSource
| Facility | $1,431.86 | $1,631.70 | $1,777.76 | |
Cigna
| Facility | $1,533.31 | $1,533.31 | $1,533.31 | |
Cigna
| Facility | AS | $150.55 | $150.55 | $150.55 |