| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,578.59 | $2,446.69 | |
CareSource
| Facility | $1,687.80 | $1,894.80 | $2,064.41 | |
Cigna
| Facility | $1,802.76 | $1,802.76 | $1,802.76 | |
Cigna
| Facility | AS | $178.36 | $178.36 | $178.36 |