| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,006.85 | $1,006.85 | $1,532.48 | |
CareSource
| Facility | $1,058.06 | $1,186.80 | $1,293.03 | |
Cigna
| Facility | $1,138.50 | $1,138.50 | $1,138.50 | |
Cigna
| Facility | AS | $111.55 | $111.55 | $111.55 |