| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,868.62 | $2,868.62 | |
CareSource
| Facility | $2,888.04 | $3,307.03 | $3,603.07 | |
Cigna
| Facility | $3,100.30 | $3,100.30 | $3,100.30 | |
Cigna
| Facility | AS | $301.58 | $301.58 | $301.58 |