| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,477.06 | $1,477.06 | |
CareSource
| Facility | $1,555.90 | $1,777.81 | $1,936.95 | |
Cigna
| Facility | $1,668.17 | $1,668.17 | $1,668.17 | |
Cigna
| Facility | AS | $163.07 | $163.07 | $163.07 |