| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,504.37 | $2,600.00 | |
CareSource
| Facility | $1,612.29 | $1,834.36 | $1,998.57 | |
Cigna
| Facility | $1,723.40 | $1,723.40 | $1,723.40 | |
Cigna
| Facility | AS | $171.16 | $171.16 | $171.16 |