| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,398.81 | $1,400.00 | $3,050.00 | |
CareSource
| Facility | $1,584.88 | $1,821.05 | $1,984.05 | |
Cigna
| Facility | $1,700.59 | $1,700.59 | $1,700.59 | |
Cigna
| Facility | AS | $168.44 | $168.44 | $168.44 |