| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,086.33 | $1,086.33 | $1,659.02 | |
CareSource
| Facility | $1,146.93 | $1,284.79 | $1,399.80 | |
Cigna
| Facility | $1,229.08 | $1,229.08 | $1,229.08 | |
Cigna
| Facility | AS | $120.64 | $120.64 | $120.64 |