| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,389.01 | $1,400.00 | $3,050.00 | |
CareSource
| Facility | $1,585.15 | $1,833.38 | $1,997.50 | |
Cigna
| Facility | $1,694.77 | $1,694.77 | $1,694.77 | |
Cigna
| Facility | AS | $168.25 | $168.25 | $168.25 |