| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,568.00 | $1,568.00 | $6,519.52 | |
CareSource
| Facility | $82,011.67 | $82,011.67 | $82,011.67 | |
CareSource
| Professional | $72,899.27 | $72,899.27 | $72,899.27 | |
Cigna
| Professional | $3,325.39 | $3,325.39 | $3,325.39 |