| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,024.33 | $1,400.00 | $5,621.91 | |
CareSource
| Facility | $1,069.45 | $1,206.43 | $1,314.43 | |
Cigna
| Facility | $1,147.16 | $1,147.16 | $1,147.16 | |
Cigna
| Facility | AS | $112.52 | $112.52 | $112.52 |