| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,594.09 | $3,050.00 | |
CareSource
| Facility | $1,698.02 | $1,957.99 | $2,133.27 | |
Cigna
| Facility | $1,815.20 | $1,815.20 | $1,815.20 | |
Cigna
| Facility | AS | $180.56 | $180.56 | $180.56 |