| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,199.67 | $1,199.67 | $1,400.00 | |
CareSource
| Facility | $1,366.88 | $1,584.30 | $1,726.12 | |
Cigna
| Facility | $1,464.13 | $1,464.13 | $1,464.13 | |
Cigna
| Facility | AS | $145.81 | $145.81 | $145.81 |