| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,514.33 | $3,050.00 | |
CareSource
| Facility | $1,609.85 | $1,851.22 | $2,016.93 | |
Cigna
| Facility | $1,724.24 | $1,724.24 | $1,724.24 | |
Cigna
| Facility | AS | $171.46 | $171.46 | $171.46 |