| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17,075.24 | $17,075.24 | $17,075.24 | |
Aetna
| Facility | 53 | $134.08 | $134.08 | $134.08 |
CareSource
| Facility | $636.25 | $858.94 | $1,049.81 | |
Cigna
| Facility | $740.59 | $740.59 | $740.59 | |
Cigna
| Facility | 53 | $143.91 | $143.91 | $143.91 |