| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,057.45 | $1,057.45 | $1,611.87 | |
CareSource
| Facility | $1,102.91 | $1,248.28 | $1,360.02 | |
Cigna
| Facility | $1,181.39 | $1,181.39 | $1,181.39 | |
Cigna
| Facility | AS | $115.95 | $115.95 | $115.95 |