| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,041.42 | $1,400.00 | $1,756.11 | |
CareSource
| Facility | $1,188.52 | $1,359.98 | $1,481.72 | |
Cigna
| Facility | $1,271.82 | $1,271.82 | $1,271.82 | |
Cigna
| Facility | AS | $126.39 | $126.39 | $126.39 |