| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,324.29 | $1,324.29 | $1,400.00 | |
CareSource
| Facility | $1,499.61 | $1,741.55 | $1,897.45 | |
Cigna
| Facility | $1,629.58 | $1,629.58 | $1,629.58 | |
Cigna
| Facility | AS | $161.66 | $161.66 | $161.66 |