| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,122.44 | $3,290.96 | |
CareSource
| Facility | $2,237.92 | $2,548.61 | $2,776.75 | |
Cigna
| Facility | $2,410.14 | $2,410.14 | $2,410.14 | |
Cigna
| Facility | AS | $238.31 | $238.31 | $238.31 |