| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,159.94 | $1,400.00 | $3,050.00 | |
CareSource
| Facility | $1,317.83 | $1,523.00 | $1,659.34 | |
Cigna
| Facility | $1,407.32 | $1,407.32 | $1,407.32 | |
Cigna
| Facility | AS | $139.58 | $139.58 | $139.58 |