| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,130.00 | $1,130.00 | $1,400.00 | |
CareSource
| Facility | $1,188.42 | $1,354.43 | $1,475.67 | |
Cigna
| Facility | $1,271.98 | $1,271.98 | $1,271.98 | |
Cigna
| Facility | AS | $124.63 | $124.63 | $124.63 |