| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,656.05 | $3,050.00 | |
CareSource
| Facility | $1,769.80 | $1,987.46 | $2,165.37 | |
Cigna
| Facility | $1,891.01 | $1,891.01 | $1,891.01 | |
Cigna
| Facility | AS | $187.01 | $187.01 | $187.01 |