| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,650.41 | $3,050.00 | |
CareSource
| Facility | $1,766.29 | $2,003.72 | $2,183.09 | |
Cigna
| Facility | $1,888.69 | $1,888.69 | $1,888.69 | |
Cigna
| Facility | AS | $187.04 | $187.04 | $187.04 |