| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,159.05 | $1,400.00 | $3,050.00 | |
CareSource
| Facility | $1,323.94 | $1,529.22 | $1,666.12 | |
Cigna
| Facility | $1,412.84 | $1,412.84 | $1,412.84 | |
Cigna
| Facility | AS | $140.11 | $140.11 | $140.11 |