| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $3,191.29 | $3,191.29 | |
CareSource
| Facility | $3,225.36 | $3,690.89 | $4,021.27 | |
Cigna
| Facility | $3,462.37 | $3,462.37 | $3,462.37 | |
Cigna
| Facility | AS | $336.62 | $336.62 | $336.62 |