| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,700.00 | $2,189.63 | |
CareSource
| Facility | $2,235.67 | $2,682.80 | $2,922.95 | |
Cigna
| Facility | $2,580.13 | $2,580.13 | $2,580.13 | |
Cigna
| Facility | 62 | $1,589.61 | $1,589.61 | $1,589.61 |