| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,577.34 | $2,577.34 | |
CareSource
| Facility | $2,595.44 | $2,973.02 | $3,239.16 | |
Cigna
| Facility | $2,785.27 | $2,785.27 | $2,785.27 | |
Cigna
| Facility | AS | $271.23 | $271.23 | $271.23 |