| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,049.69 | $1,049.69 | $1,400.00 | |
CareSource
| Facility | $1,187.38 | $1,374.12 | $1,497.12 | |
Cigna
| Facility | $1,277.76 | $1,277.76 | $1,277.76 | |
Cigna
| Facility | 62 | $792.94 | $792.94 | $792.94 |