| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,467.06 | $3,050.00 | |
CareSource
| Facility | $1,576.75 | $1,806.52 | $1,968.22 | |
Cigna
| Facility | $1,687.69 | $1,687.69 | $1,687.69 | |
Cigna
| Facility | AS | $167.58 | $167.58 | $167.58 |