| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,812.55 | $3,050.00 | |
CareSource
| Facility | $1,904.98 | $2,182.48 | $2,377.84 | |
Cigna
| Facility | $2,043.18 | $2,043.18 | $2,043.18 | |
Cigna
| Facility | AS | $202.55 | $202.55 | $202.55 |