| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,478.29 | $2,478.29 | |
CareSource
| Facility | $2,501.06 | $2,863.81 | $3,120.16 | |
Cigna
| Facility | $2,682.64 | $2,682.64 | $2,682.64 | |
Cigna
| Facility | AS | $261.27 | $261.27 | $261.27 |