| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,198.22 | $1,198.22 | $2,300.00 | |
CareSource
| Facility | $1,271.19 | $1,441.43 | $1,570.46 | |
Cigna
| Facility | $1,358.21 | $1,358.21 | $1,358.21 | |
Cigna
| Facility | AS | $133.02 | $133.02 | $133.02 |