| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,916.58 | $2,916.58 | |
CareSource
| Facility | $2,939.37 | $3,364.80 | $3,666.01 | |
Cigna
| Facility | $3,153.34 | $3,153.34 | $3,153.34 | |
Cigna
| Facility | AS | $307.08 | $307.08 | $307.08 |