| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,200.36 | $1,400.00 | $2,300.00 | |
CareSource
| Facility | $1,254.50 | $1,419.47 | $1,546.53 | |
Cigna
| Facility | $1,342.74 | $1,342.74 | $1,342.74 | |
Cigna
| Facility | AS | $131.97 | $131.97 | $131.97 |