| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,529.82 | $3,050.00 | |
CareSource
| Facility | $1,638.29 | $1,878.55 | $2,046.72 | |
Cigna
| Facility | $1,753.40 | $1,753.40 | $1,753.40 | |
Cigna
| Facility | AS | $174.63 | $174.63 | $174.63 |