| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,271.08 | $1,271.08 | $1,400.00 | |
CareSource
| Facility | $1,445.83 | $1,617.37 | $1,762.14 | |
Cigna
| Facility | $1,554.94 | $1,554.94 | $1,554.94 | |
Cigna
| Facility | AS | $152.97 | $152.97 | $152.97 |