| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,078.23 | $1,078.23 | $1,643.98 | |
CareSource
| Facility | $1,119.40 | $1,273.14 | $1,387.11 | |
Cigna
| Facility | $1,199.82 | $1,199.82 | $1,199.82 | |
Cigna
| Facility | AS | $117.55 | $117.55 | $117.55 |