| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,364.19 | $2,364.19 | |
CareSource
| Facility | $2,382.06 | $2,727.25 | $2,971.39 | |
Cigna
| Facility | $2,556.00 | $2,556.00 | $2,556.00 | |
Cigna
| Facility | AS | $248.89 | $248.89 | $248.89 |