| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,559.34 | $2,419.58 | |
CareSource
| Facility | $1,661.01 | $1,873.79 | $2,041.52 | |
Cigna
| Facility | $1,773.58 | $1,773.58 | $1,773.58 | |
Cigna
| Facility | AS | $175.11 | $175.11 | $175.11 |