| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,700.00 | $2,172.71 | |
CareSource
| Facility | $2,210.35 | $2,652.42 | $2,889.85 | |
Cigna
| Facility | $2,553.94 | $2,553.94 | $2,553.94 | |
Cigna
| Facility | 62 | $1,572.60 | $1,572.60 | $1,572.60 |