| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,017.49 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,158.50 | $1,311.89 | $1,429.33 | |
Cigna
| Facility | $1,240.63 | $1,240.63 | $1,240.63 | |
Cigna
| Facility | AS | $123.07 | $123.07 | $123.07 |