| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,089.56 | $13,299.06 | $15,922.06 | |
CareSource
| Facility | $1,155.67 | $1,299.14 | $1,415.43 | |
Cigna
| Facility | $1,239.89 | $1,239.89 | $1,239.89 | |
Cigna
| Facility | AS | $121.88 | $121.88 | $121.88 |