| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,262.41 | $1,388.65 | $40,163.33 | |
CareSource
| Facility | $1,415.73 | $1,573.52 | $1,714.38 | |
Cigna
| Facility | $1,515.20 | $1,515.20 | $1,515.20 | |
Cigna
| Facility | AS | $147.66 | $147.66 | $147.66 |