| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,400.00 | $1,947.40 | $1,947.40 | |
CareSource
| Facility | $1,815.03 | $2,450.29 | $2,994.80 | |
Cigna
| Facility | $2,107.37 | $2,107.37 | $2,107.37 | |
Cigna
| Facility | AS | $205.39 | $205.39 | $205.39 |