| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,156.66 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,199.57 | $1,366.14 | $1,488.43 | |
Cigna
| Facility | $1,284.00 | $1,284.00 | $1,284.00 | |
Cigna
| Facility | AS | $126.27 | $126.27 | $126.27 |