| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,576.73 | $2,600.00 | |
CareSource
| Facility | $1,685.20 | $1,906.70 | $2,077.38 | |
Cigna
| Facility | $1,797.43 | $1,797.43 | $1,797.43 | |
Cigna
| Facility | AS | $178.36 | $178.36 | $178.36 |