| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,008.96 | $1,400.00 | $1,701.82 | |
CareSource
| Facility | $1,156.81 | $1,317.94 | $1,435.91 | |
Cigna
| Facility | $1,235.10 | $1,235.10 | $1,235.10 | |
Cigna
| Facility | AS | $122.70 | $122.70 | $122.70 |