| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,338.37 | $4,713.79 | $4,713.79 | |
CareSource
| Facility | $905.96 | $1,036.48 | $1,129.25 | |
Cigna
| Facility | $971.99 | $971.99 | $971.99 | |
Cigna
| Facility | AS | $96.90 | $96.90 | $96.90 |