| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,270.43 | $1,270.43 | $2,600.00 | |
CareSource
| Facility | $1,423.32 | $1,582.32 | $1,723.96 | |
Cigna
| Facility | $1,524.10 | $1,524.10 | $1,524.10 | |
Cigna
| Facility | AS | $148.46 | $148.46 | $148.46 |