| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,145.59 | $1,400.00 | $2,600.00 | |
CareSource
| Facility | $1,311.35 | $1,503.66 | $1,638.25 | |
Cigna
| Facility | $1,403.28 | $1,403.28 | $1,403.28 | |
Cigna
| Facility | AS | $139.43 | $139.43 | $139.43 |