| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $2,521.32 | $2,521.32 | |
CareSource
| Facility | $2,537.31 | $2,905.03 | $3,165.08 | |
Cigna
| Facility | $2,723.80 | $2,723.80 | $2,723.80 | |
Cigna
| Facility | AS | $265.26 | $265.26 | $265.26 |